When you’re covered by ACC, and when you’re not
Most ACC claims are for physical injuries caused by accidents – like broken, fractured or dislocated bones, muscle tears and strains, deep cuts or tears (“lacerations”), and sprains.
Most claims involve an “accident” in the everyday sense of the term, like a car crash, or falling off a ladder at work or at home. But sometimes there are less straightforward cases, and whether you’re covered by ACC will depend on if you meet the criteria or legal definition of “accident” set out in the Accident Compensation Act (see: “Injuries caused by accidents” ).
Usually ACC only covers injuries caused by a specific event, rather than by a long-term, gradual process. But sometimes ACC will cover conditions caused by long-term exposure to something harmful at work or by an action repeated over a long time as part of your work (see: “Conditions caused gradually: Covered only if work-related”).
In a few situations, non-physical injuries like panic disorders or depression will also be covered, depending on how they were caused (see: “Mental injuries: sometimes covered”).
FAQs
Your injury must be because of an accident. We won't cover things like illness, conditions from ageing and emotional issues.
How much does ACC sensitive claim payout? ›
We'll pay up to 80% of your income as weekly compensation if you're unable to work or do your usual duties because of an injury we're covering.
Does ACC pay out for PTSD? ›
If we accept your claim for a physical injury, we can also cover mental injuries resulting from that injury. For example, post-traumatic stress disorder after a physical assault.
Can you go on ACC for stress? ›
Yes In order for mental injury to be covered, it must be diagnosed as being a clinically significant behavioural, cognitive, or psychological dysfunction. For work-related mental injury to be covered, it must be caused by a single, sudden event that occurred in a person's place of employment.
How long can I stay on ACC? ›
If you received weekly ACC payments for an injury before you turned 65. If you're injured before you turn 63, you'll be eligible for weekly ACC payments until you turn 65. If you're injured after you turn 63, you'll be eligible for weekly ACC payments for two years from the date your payments started.
Does ACC pay lump sums? ›
Clients who suffer a permanent or long-term impairment resulting from an injury may be entitled to lump sum compensation or an independence allowance (IA).
What does 30% impairment mean? ›
A 30% impairment is the minimum threshold impairment level necessary to be entitled to an impairment lump sum claim if you have a psychological injury.
What is the average compensation payout for psychological injury? ›
Compensation payouts for psychological injury
| Occupation | Number of claims | Average claim payment |
|---|
| Salespersons and sales assistants | 260 | $13,400 |
| Administrative workers | 250 | $35,900 |
| Social and welfare professionals | 230 | $24,000 |
| All occupations (including above and others) | 7820 | $23,600 |
7 more rowsIf you (the worker) have a permanent impairment as a result of a work related injury or illness, you may be entitled to receive a lump sum payment as compensation. This is in addition to weekly payments, medical and related expenses that may generally be available through the workers compensation system.
How do you prove psychological injury? ›
To prove emotional pain and suffering, you require medical evidence from a treating health professional, preferably a psychologist or psychiatrist, which details the extent of your injuries.
Guideline Compensation Payouts For Psychological Injury Claims
| Injury Type | Compensation Amount |
|---|
| Moderate psychiatric damage | £7,150 to £23,270 |
| Less severe psychiatric damage | £1,880 to £7,150 |
| Severe PTSD | £73,050 to £122,850 |
| Moderately severe PTSD | £28,250 to £73,050 |
5 more rowsSep 11, 2024
A severe PTSD case could attract a payment of £73,050 to £122,850. If the condition is deemed moderately severe, the suggested bracket is £28,250 to £73,050. A payment for moderate PTSD could lead to compensation of £9,980 to £28,250. Finally, for less severe cases, the recommended bracket is £4,820 to £9,980.
Is carpal tunnel syndrome covered by ACC? ›
Does ACC cover CTS? ACC can only cover CTS if it's been caused by features of the tasks you do at work. Your doctor can make a claim for you. ACC will then contact you for more information – such as your work and medical history - to help us make a decision on your claim.
Is a hernia covered by ACC? ›
No matter how the injury happened. No matter how old you are, or whether you are employed, retired, a child, on a benefit or studying. Most hernia injuries will be covered if they were caused by an accident or medical treatment. ACC has to be satisfied that you have suffered personal or physical injury.
Is appendicitis covered by ACC? ›
ACC doesn't cover things like illness, conditions from ageing and emotional issues. bands. if you have appendicitis and need an emergency trip to the hospital • you get skin burn from the sun, wind or snow • you have unexplained back pain that gets worse over time. For more information visit the ACC website here.
Does ACC cover post-concussion syndrome? ›
Consequently, ACC no longer accepts 'post-concussion syndrome' as a covered injury. Where clients/patients have persisting symptoms that clinicians consider are caused by concussion, the appropriate covered injury would be 'concussion'.
