What support can I get?

Lump sum payment

If you’re permanently impaired as a result of an injury that occurred after 1 April 2002, you may be eligible for a lump sum payment. Find out about whether your eligible for the lump sum assessment, how to apply for it, and what happens at the assessment.

Checking your eligibility for assessment

Before you start the lump sum claim process, it’s a good idea to check to make sure you are eligible for the lump sum assessment (we make these same checks). Make sure your:

  • claim has been accepted for cover by us
  • injury occurred on or after 1 April 2002.

Lump sum payments are in addition to any other support you may receive from ACC.

Special rules around injuries and dates

There are some special rules that apply if your injury is one of the following. In these cases, the date of injury is usually considered to be the date that you first sought treatment or the date that you were first unable to work, so this date needs to be on or after 1 April 2002 for you to be eligible for a lump sum payment.

If the injury is a:

  • Treatment injury – the date of the treatment that caused the injury has to be on or after 1 April 2002
  • Sensitive claim (physical and/or mental injury arising from sexual abuse or assault) – the date that the abuse or assault last occurred has to be on or after 1 April 2002
  • Work-related gradual process, disease or infection – in most cases, the last date that you performed the task that caused the injury or that you worked in the risky work environment has to be on or after 1 April 2002.

    If the date of injury is on or after 1 August 2008, you may be able to choose between a lump sum payment or an independence allowance. Contact ACC Claims for more information.

Your treatment and recovery must be complete

Before you can apply for a lump sum assessment your:

  • treatment and recovery must be complete and it appears there is likely to be a permanent impairment (your doctor will confirm this), or two years have passed since the date of your injury.
  • injury must be stable. An injury is considered stable if it’s not expected to improve within the next 12 months, with or without medical treatment.

What ‘impairment’ means

Impairment means:

  • the loss of a body part, eg amputation of a finger
  • loss of function in a body part, eg loss of movement in fingers.

Impairment is not the same as disability. A disability relates to not being able to perform an activity because of an impairment – in other words, a disability (not being able to do something) results from an impairment.”

For example, a bank manager and a concert violinist have a similar injury – the loss of the end of their middle finger. Their level of impairment will be the same (the loss of the end of their finger). The level of disability will be significantly different as the bank manager will be able to return to work but the concert violinist can no longer play well enough to stay in the same job.

Note:
Your level of impairment sets the lump sum amount.

Help you can get if you were injured before 1 April 2002

If you’re permanently impaired as a result of an injury that occurred before 1 April 2002, you may still be eligible for an independence allowance, to find out more go to:

Independence allowance.

Apply for a lump sum compensation assessment

If you’ve been told by your doctor that your treatment and recovery is complete, or two years have passed since the date of your injury, then you should apply:

  1. Contact us for a copy of the application pack. This contains an application form, and all other material you’ll need to make your claim. You’ll also receive instructions from us about how to complete the application form with your doctor.
  2. Complete the application form with your doctor. Your doctor must confirm that your injury is stable (unless it’s more than two years since you were injured) and that permanent impairment is likely.
  3. Return the completed form and medical certificates to us, along with a copy of all relevant medical records.
  4. We’ll let you know if you’re eligible to be assessed within a week of receiving your application. This will be in writing and we’ll phone you to answser any questions you may have.

Note:
If you’re eligible to be assessed, it can take up to four months from receipt of your applcation to the time you receive a decision. We’ll keep in touch with you with regular updates.

Applying if you’re living overseas

You’ll need to be aware of the following if you’re applying from overseas:

  • Lump sum payments and independence allowances are paid in New Zealand dollars, into your New Zealand bank account.
  • Your application form and medical certificates (completed with your overseas doctor) must be in English
  • We require details from your overseas doctor of their registration as a medical practitioner, medical qualifications and contact details
  • We’ll arrange for your impairment to be assessed by an assessor in New Zealand using the medical information provided (however the assessor may also require the assistance of your overseas doctor).
  • In some cases we’ll require you to return to New Zealand for an assessment.
  • We’re not required to meet any costs incurred by you while you are overseas, including your doctors’ consultations, or travelling to New Zealand for an assessment (if required).

How you’re assessed for a lump sum

The assessment is fully funded by us.

If you’re eligible to be assessed for lump sum we’ll refer you to an assessor who will

  • contact you to arrange an appointment
  • determine your level of impairment using the American Medical Association’s Guide to the Evaluation of Permanent Impairment fourth edition, and at the same time with the ACC User Handbook to AMA4 (PDF 3.8M)
  • send the results to us.

Levels of impairment and lump sum payments

Your level of impairment must be 10% or more to be eligible for a lump sum payment.

Examples of impairment levels:

  • 0 - 5% impairment, eg common lower back injury – lifting/bending, would not be eligible for an entitlement
  • 10% impairment, eg severe damage to the ligaments of the knee, would provide an entitlement
  • 32% impairment, eg amputation of a leg below the knee, would provide an entitlement
  • 80% or more impairment, eg paraplegia, would provide the maximum entitlement.

Notes:

  • If you sustain more than one injury the impairments will be combined using a mathematical formula that ensures that compensation for multiple injuries does not exceed the maximum payable
  • You cannot receive a lump sum payment and independence allowance for the same injury.

What happens if you’re eligible for a lump sum payment

If you’re eligible for a lump sum payment we’ll phone you and send you a letter informing you of our decision. The payment will be paid into your bank account. A lump sum payment is not taxed.

Setting the lump sum amount you’ll receive

  • The amount of lump sum payable is based on the percentage of your assessed impairment.
  • Lump sum is one off non-taxable payment.
  • The amount is specified by legislation.
  • Lump sum compensation increases based on your level of impairment.

Getting a reassessment

If your impairment has changed, or you’ve a further injury causing you impairment, you can apply to be reassessed at any time after your initial assessment. However, you can’t have more than one reassessment in a 12 month period.

Lump sum payments for someone who dies

To be eligible for a lump sum a client must have been assessed prior to their death, and all the following must apply:

  • the client suffered a personal injury for which they have cover
  • the client survived the injury for no fewer than 28 days
  • the impairment assessment established that the client’s injury resulted in a whole person impairment (WPI) of 10% or above

Note:
If a client dies after their assessment but before the payment is made, we pay compensation to their estate.

What to do if you’re unhappy about a lump sum decision

If you’re unhappy about our decision or the results of your assessment, talk to your ACC Client Services staff member as they’ll be happy to answer any questions or work with you to resolve your concerns.

You also have the right for the decision to be independently reviewed. For reviews, you need to apply within three months of our decision, unless factors outside your control stopped you from applying in time.

Important: The help you’ll get depends on your individual circumstances. Contact us if you want to know other ways we can help.

Related legislation

Accident Compensation Act 2001 Section 380: Lump Sum Compensation under former Acts (external link)

Accident Compensation Act 2001, Schedule 1, Clauses 54 to 62 (external link)

Updated: 13 June 2016
Reviewed: 24 April 2015