Probst's Fight for ACC Coverage After Tennis Injury

On a suburban court, in a friendly family doubles match, a single serve changed everything.

Three-quarters of the way through the first set, Probst – a former competitive tennis player who has played since childhood – wound up for what he reckons was a 112km/h delivery. Harder than anything else he’d hit that day. Hard enough, he says, to tear his shoulder apart.

“Right after I hit the serve, I thought, wow, my shoulder hurts.”

He kept going. Competitors do. By the next set, reality caught up. He could no longer hit a backhand without pain. Tennis stopped. Then swimming – three times a week before the incident – went too. Surfing, paddling, anything that asked his right arm to pull or lift, all gone in a single afternoon.

The medical picture was stark. An MRI revealed a full-thickness tear of the supraspinatus tendon with 16mm tendon retraction, tendinopathy and muscle atrophy. His orthopaedic surgeon recommended surgical repair. Probst, “incredibly active for his age” and with no prior shoulder problems, expected the system to back him.

ACC did not.

ACC’s clinical adviser, a physiotherapist, advised declining cover. The recorded mechanism of injury – “hitting the ball awkwardly and hurting his shoulder” and an “awkward overhead shot and wrenching his shoulder” – was, in his view, not the kind of unexpected high-energy force usually associated with a traumatic rotator cuff tear.

He pointed to the tendon retraction, tendinopathy, muscle changes and Probst’s age as signs that degeneration, not a single incident, sat at the heart of the damage.

Probst bristled. To him, the description stripped the force out of the moment. This wasn’t a casual tap gone wrong. It was a full-blooded serve, struck as hard as he could, and he felt something go immediately.

He challenged ACC on his own first.

“Because it was wrong,” he said of his decision to keep fighting. “When people are trying to get away with something that is incorrect and take advantage of people’s unwillingness or inability to challenge stuff, that just gets me fired up.”

The fight dragged on. The injury came in February 2024. ACC declined cover in January 2025. In between, Probst stopped doing the things that had defined his active life, and waited.

When the independent reviewer finally ruled, the decision landed squarely on his side.

The review found that Probst’s tear was caused by the February 2024 accident, not wholly or substantially by a pre-existing or degenerative process. The reviewer noted that ACC’s clinical adviser had not considered the mechanism of injury as Probst himself described it and had not had access to the original ultrasound or initial physiotherapy notes when forming his opinion.

Crucially, the reviewer highlighted several anchors: Probst experienced immediate pain; there was a clear temporal link between the serve and his symptoms; he had been highly active without shoulder issues beforehand; and the MRI report did not show moderate or severe degeneration.

“Ultimately, [the ACC physiotherapist] has misunderstood the mechanism of injury, has commented without a full clinical picture, and has not provided any reasoning on why he considers that the injury was caused wholly or substantially by degeneration, with a no more than minimal contribution by the accident event,” the decision stated.

The reviewer also drew a sharp contrast between the experts. Probst’s orthopaedic surgeon had examined him in person. The physiotherapist had conducted only a paper review. On that basis, the surgeon’s opinion on the nature of the tear carried greater weight.

ACC accepted the call.

ACC head of service operations Phil Riley acknowledged that cases like Probst’s sit in a clinically tricky space.

“Cases like Mr Probst’s, where ACC is assessing whether a condition was caused by an accident or degenerative changes can be clinically complex, and clinical professionals may reach different conclusions despite assessing the same information,” he said.

Riley stressed that treating specialists play an important role, but their views are weighed alongside other medical material, and ACC may seek further specialist advice. He pointed to guidelines developed with orthopaedic specialists “to help support consistent and accurate decision making.”

“After assessing the available clinical evidence, including the guidelines, we were unable to determine that Mr Probst’s condition was caused by his accident,” Riley said, explaining the original decline.

At the review hearing, Probst supplied more information. This time, it was enough.

“We accept the reviewer’s decision and have approved cover and funded Mr Probst’s surgery,” Riley said.

For Probst, the verdict brought relief and frustration in the same breath.

“I was happy that the time and the money that I’d expended, and the mental effort had paid off, that you could prevail against an unjust decision.
“But it is bittersweet because it could have been done a year earlier and I could have risked further injury during that time period.”

The reviewer awarded him $1218.13 in review costs. After ACC’s contribution, he still carried $3206.87 in legal bills.

Riley noted that reviews are free to lodge. Clients do not need a lawyer; they can represent themselves or lean on an advocate, family member or other representative, and ACC may contribute to review-related costs. He also pointed to ACC’s free Navigation Service, which offers independent guidance and support.

Behind Probst’s case sits a broader shift. ACC figures show the proportion of rotator cuff surgery purchase orders declined rose from 22% in 2024 to 35% in 2025. Across all orthopaedic surgery, the decline rate climbed from 18% to 26%.

Those numbers, and the stories he has heard from others who believe their claims were wrongly turned down, pushed Probst to speak publicly.

His message to anyone convinced ACC has misread their case is blunt.