Understanding causation video transcript
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Screen shows Understanding causation. Clock shows watch time of 3 minutes 45 seconds.
Text displays Dr Peter Burt, Clinical Advice Manager.
Peter is sitting in a chair facing the camera. A pot plant, water jug, cup of water and pen and notepad sit on a small table beside him.
Transcript
Dr Peter Burt: After you lodge a claim with us there are a few things we need to think about before we can decide on cover for your patient.
One of those key things is causation which is very closely linked with cover.
Essentially, we need to be sure there’s a direct link between the person’s injury and their accident.
To help explain what we mean by causation, we’re going take you through what we consider when making cover decisions.
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Screen shows What is causation? Clock shows watch time of 40 seconds.
Screen cuts back to Peter in the chair.
Transcript
When we talk about causation, what we mean is that it’s more likely than not, the person’s identified injury was caused by their accident.
In some instances, drawing a link between the injury and the accident is simple.
For example, if a person falls off a ladder and breaks their arm, we can be confident we’ve identified causation.
In these cases, we’ll be quick to approve cover, meaning the person can receive the appropriate support they need for their recovery.
But we know people get injured in many different ways or have pre-existing health conditions which can make this decision trickier.
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Screen shows What about complex injuries? Clock shows watch time of 1 minute 14 seconds.
Screen cuts back to Peter in the chair.
Transcript
In situations where causation isn’t immediately clear, we’ll need to be satisfied the accident was the major or substantive cause of the injury.
If the injury is complex or if the claim was lodged more than 12 months after the injury happened, it might take us a bit longer to do that.
That’s because we consider the evidence for each claim before we make a decision.
For example, if a person with a background of osteoarthritis has a fall and suffers a meniscal tear to their knee, causation might be more difficult to determine.
While time between the injury and accident is important in most cases, there are other factors we may consider. These include:
How the accident or injury happened
Whether the force of the accident was enough to cause the person’s acute injury
And whether there were any underlying conditions or factors which contributed to the injury.
Our legislation doesn’t allow us to cover pre-existing conditions which have been aggravated by an accident.
But cover may be possible if the accident has caused a new injury.
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Screen shows Why is causation important? Clock shows watch time of 41 seconds.
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Transcript
The ACC-funded treatment, rehabilitation and care our clients receive is based on their unique injury-related needs.
That could be a range of services such as home help, physiotherapy, rehabilitation equipment and in some cases weekly compensation.
Over time, your patient’s needs might change too so it’s important to let us know if you need to update their diagnosis.
Understanding causation helps us tailor the appropriate support to get our clients back to independence.
So there you have it, the basics of causation. Thanks for watching.
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Screen shows Causation.
Screen changes to roll through four statements: Means the accident more likely than not caused the injury. Is considered on a case-by-case basis. Allows clients to receive appropriate supports.
Screen changes to show For more information and resources visit acc.co.nz/health-providers.
Screen changes again to show the ACC logo and tagline He Kaupare. He Manaaki. He Whakaora. Prevention. Care. Recovery.