About medical appeals

The Medical Appeals Board is an independent body established to ensure that correct and fair decisions are made about benefit eligibility and obligations, within the legislation.

Information

If a client does not agree with a decision made on medical grounds to decline or cancel certain benefits or payments, they can appeal the decision to the Medical Appeals Board.

  • Introduction

    The benefits and payments that can be appealed are as follows.

    • Child Disability Allowance.
    • Supported Living Payment on the ground of health condition, injury or disability
      (This includes countries where New Zealand has a Reciprocal Agreement under which clients can receive the Supported Living Payment).
    • Jobseeker Support.
    • Veteran's Pension when they are under 65 years of age with a health condition, injury or disability that is not related to their service. Other appeals in relation to Veteran's Pension are administered by Veteran's Affairs New Zealand.

    The Medical Appeals Board takes a fresh look at all the information about a client's health condition or disability, and the impact on their capacity for work as related to that condition or disability.

    The medical appeal process is an important part of ensuring that correct decisions are made on a case by case basis. The hearing is an exercise of the client's right to appeal a decision made by the Ministry and for the Board to review the decision in a fair and independent manner.

    A client can also appeal to the Medical Appeals Board if they are on Jobseeker Support, Supported Living Payment, Sole Parent Support, or are a partner of a main beneficiary and disagree with a decision made on medical grounds regarding their work obligations or work preparation obligations.

    A client may appeal a decision that they do not have a good and sufficient reason for not complying with a drug test obligation and/or failing to apply for work that requires drug tests, on the basis that they are addicted to or dependent on controlled drugs.

    The role of the Medical Appeals Board is to take an impartial look at all the information available on the client's health condition and capacity for work.

  • Medical Appeals Board members

    A Medical Appeals Board is made up of three members and can include:

    • health practitioners
    • rehabilitation professionals including:
      • a person who is professionally engaged in the rehabilitation of people who are sick, have had an accident, or have a disability
      • occupational therapists
      • physiotherapists
      • nurses
      • psychologists
    • others with appropriate expertise in the fields of vocational training or vocational support for persons with a health condition, injury or disability.

    Any practitioner who provided information used to help make the original decision on a person's eligibility or obligations will not be included on the Medical Appeals Board for that person's hearing.

  • The hearing process

    The client is encouraged to attend the hearing and present any additional medical documentation and/or evidence to support their appeal. If the client chooses to attend the hearing, a representative from Work and Income will also attend.

    If the client decides not to attend the hearing, the representative from Work and Income will also not attend; however, the Medical Appeals Board is able to convene a hearing and consider the appeal based on the information provided.

    The hearing may last up to an hour and the client is welcome to bring others with them to the hearing such as an advocate, agent, lawyer and/or support person.

    In some cases the Medical Appeals Board may request the client be re-examined by a specialist or other health practitioner to assist in reaching their decision. The client may decline this, in which case the information already provided will be used to make a decision.

    Decisions are expected within one to two weeks of the hearing and a copy of the decision is provided to the client.

    A client may choose to withdraw their appeal at any time.

    The decision of the Medical Appeals Board is final and there is no further right of appeal on medical grounds.

  • Further information

    Contact us if you have any questions about the medical appeals process or want to know more about the hearings.

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