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Gradual disease/infection caused by work A personal injury caused by the gradual onset of a condition, a disease or an infection that is related to a work task you do, or the environment you work in, may be covered by ACC. What is a gradual process injury? Gradual process injuries are those that occur over a period of four weeks or more. Work-related disease or infection, through a single exposure to the source of an infection, is not regarded as a gradual process injury. If you suffer hearing loss caused by noise in your workplace, you may be covered by ACC for a work-related gradual process. There is a slight variation in what you need to do and the information we require for a hearing loss claim. For non-work-related hearing loss claim information, see Hearing loss and Services for hearing loss. See Look after your hearing for more information about noise-induced hearing loss. What do I need to do? 1. If you suffer a work-related gradual process, disease or infection, see a health professional as soon as possible. Don’t wait until you feel better, as this can often make the injury worse and your recovery longer. Note: The Accident Compensation Act 2001 lists the health professionals whose treatment ACC can contribute towards. See the list of approved treatment providers. The date of injury for gradual process claims is usually the date you first sought treatment from a registered medical practitioner for that injury, but can also be the date from which you were unable to work. 2. Your health professional (doctor, physiotherapist, dentist, nurse etc) will help you fill out an ACC claim form and send it to us. Note: ACC can only accept injury claim forms for work-related hearing loss from a doctor, an ear, nose and throat (ENT) specialist, or other medical practitioner. Usually you will need to pay at least part of the cost of the first visit to a health professional; they can claim the rest back. If you are asked to pay the full amount, keep the receipt, because you may be able to claim some of the money back. 3. If you need to take time off work because of your injury, discuss this with your doctor or nurse practitioner. They will complete a medical certificate for you if they confirm that you do need time off work. Important note: Check if your employer is an accredited employer under the ACC Partnership Programme. If they are, send the claim form to them because they will make the cover decision and manage the claim. What information does ACC need from me? ACC needs the same information for all claims in the first instance. See Injury in New Zealand. Note: If you work for an accredited employer, substitute them wherever ACC is referred to in this section. After ACC receives your claim form, we will need to get more information about your injury to help us decide if it was caused by a work-related gradual process, disease or infection. We will send the following forms to you and ask you to arrange for them to be returned to ACC within 14 working days: a client consent form and a client questionnaire completed by you a questionnaire completed by your past and present employers a questionnaire completed by your doctor (not required for work-related hearing loss claims) If your claim is for work-related hearing loss, we will ask you to see an ear, nose and throat (ENT) specialist, who will assess your condition, arrange a hearing test and send us a report. How does ACC decide if I am covered? See Injury in New Zealand for some of the standard questions ACC considers when assessing cover. The key tests for deciding cover for a work-related gradual process, disease or infection claim are that: there is a property or characteristic in your work task or environment (some feature, such as a repetitive movement or noisy workplace) that causes or contributes to your injury where the property or characteristic exists both in and outside of work, the one found at work is regarded as being more likely to be the cause of your injury the risk of injury to you in your job or work environment is not significantly greater than for someone who doesn’t do your job, or work in your environment. Note: If a significantly greater risk is not proved, ACC can decline your claim. ACC can only cover gradual process, disease or infection injuries if they are workrelated. Therefore, we cannot cover hearing loss caused by: the ageing process non-occupational noise exposure, such as mowing lawns at home, attending rock concerts or recreational shooting congenital (existing from birth) or hereditary conditions, or ear conditions such as middle ear disease, glue ear or wax war noise, unless it is a work-related personal injury. How long might ACC take to decide? Gradual process claims are assessed for cover within two months of being lodged, during which time ACC will investigate your claim and let you know the cover decision. Sometimes a decision on a claim cannot be made within two months because additional information is required. If that happens in your case, ACC will extend the timeframe for making a decision, up to a maximum of four months from the date the claim was lodged. You will be told about the extension as soon as possible. Gradual process hearing loss claims usually take the full four months to assess because of the time it takes to get a report from an ENT specialist. If we can’t make a decision within four months, ACC will contact you. Occasionally, a decision cannot be made before the first extension expires. We will seek your written agreement for any further extensions. A decision must be made within nine months of the date the claim is lodged. You can help speed the process by completing and returning the consent form and client cover questionnaire, and forwarding the employer and medical (if required) questionnaires, promptly. Until we tell you whether ACC can accept your claim, we will pay for the costs of investigating and deciding if you are covered, including: gathering information from your doctor medical tests required to confirm a diagnosis specialist reports (including ENT specialist assessment) workplace assessments your travel costs to cover assessment appointments contribution towards treatment costs that do not require prior approval, eg physiotherapy or doctor visits. If you have to pay for any treatment while you are waiting for a cover decision to be made, keep receipts of your costs and get medical certificates for any time you have off work. ACC cannot pay for other assistance unless your claim is accepted for cover and your needs are assessed. What happens next? We will contact you by phone or letter to let you know if your claim is accepted. If it is declined, we will tell you why. If your claim is accepted, we may be able to help with the cost of treatment and other assistance, such as rehabilitation or weekly compensation. See What support can I get? Your actual entitlement depends on your individual circumstances. Please contact us to confirm if you are eligible, or to identify other ways in which we can help. See Contact ACC Claims for our contact details. If your claim is declined, ACC will contribute towards the cost of treatment that does not require prior approval and which you have had between the time the claim form was completed and the decision to decline the claim was made. Note: If you are unhappy with the decision, you can ask for it to be reviewed. See What if I have problems with a claim? Look after your hearing If, like many people, you find that work-related, noise-induced hearing loss causes very few problems in your everyday life, then taking steps to protect your hearing may be all you need to do at the moment. Make sure you act on the advice provided during your assessment; if you’re working, talk to your employer about it. See Noise induced hearing loss for more information. Related legislation Accident Compensation Act 2001 Section 30: Personal Injury caused by work-related gradual process, disease or infection (external website) Section 61: Decision on claim for noise-induced hearing loss caused by workrelated gradual process (external website) Schedule 2: Occupational diseases (external website)