Workers' compensation prosecutions
The Workers' Compensation Regulator is responsible for investigating and commencing proceedings for alleged offences against the Workers' Compensation and Rehabilitation Act 2003 (the Act).
If a workers' compensation insurer comes across information which supports a reasonable belief that an offence has been committed, the insurer must provide that information to Workers’ Compensation Regulatory Services without delay.
Authorised Persons within Workers’ Compensation Regulatory Services will then investigate the potential offence to determine if there is sufficient evidence to support a recommendation being made to the Workers’ Compensation Regulator that a prosecution should be commenced.
Who can be prosecuted?
Investigations and proceedings can be commenced against any person including a worker or a claimant, employer, service provider, or any other person or business. View the Workers’ Compensation Regulator prosecutions policy.
Offence | Maximum Penalty |
Contravening general obligation to insure (s. 51) | 275 penalty units (currently $36,698.75) |
Employer’s failure to comply with duty to report injury (s. 133) | 50 penalty units ($6,672.50) |
Worker’s failure to notify of a return to a calling (s. 136) | 50 penalty units ($6, 672.50) |
Failure to comply with employer’s obligation to appoint rehabilitation and return to work coordinator, obligation to have workplace rehabilitation policy and procedures or obligation to assist or provide rehabilitation (s. 226, 227, 228) | 50 penalty units ($6, 672.50) |
Dismissal of injured worker only after 12 months (s.232B) | 40 penalty units ($5,338) |
Offences involving fraud (s.533) | 500 penalty units ($66,725) or 5 years imprisonment |
False or misleading information or documents (s.534) | 150 penalty units ($20,017.50) or 1 years imprisonment |
Duty to report fraud or false or misleading information or documents (s.536) | 50 penalty units ($6, 672.50) |
Employer’s use of workers’ compensation documents for a purpose relating to the employment of a worker (s. 572A) | 100 penalty units ($13,345) |
Failure of contractor to give principal contractor document confirming insurance status (s. 576C) | 25 penalty units ($3,336.25) |
Breach of restriction on disclosure by principal contractor of information obtained under part 1A (s. 576E) | 100 penalty units ($13,345) |
In the 2021/22 financial year, the Workers’ Compensation Regulator:
- Received 91 referrals for investigation
- Commenced 29 prosecutions
- Successfully prosecuted 12 matters
- Recovered $545,000 in restitution on behalf of insurers
- Secured fines totalling $122,000
In the 2020/21 financial year, the Workers’ Compensation Regulator:
- Received 69 referrals for investigation
- Commenced 27 prosecutions
- Successfully prosecuted 16 matters
- Recovered $547,000 in restitution on behalf of insurers
- Secured fines totalling $5,000
In the 2019/20 financial year, the Workers’ Compensation Regulator:
- Received 66 referrals for investigation
- Commenced 25 prosecutions
- Successfully prosecuted 12 matters
Workers’ Compensation Regulatory Services publishes information about prosecution outcomes for certain offences under workers’ compensation laws as well as actions taken by WorkCover Queensland to administratively enforce compliance with workers’ compensation laws by recovering unpaid premium and applying administrative penalties to employers who do not hold adequate workers’ compensation insurance.
Publishing prosecution and administrative compliance outcomes encourages compliance with Queensland’s workers’ compensation laws by:
- educating workers, employers and the community about their obligations under the Act and consequences of not complying with these; and
- providing information about how to prevent similar breaches.
Publishing principles
We aim to ensure that all published information is accurate, impartial and balanced, and encourages compliance with Queensland's workers’ compensation laws.
Publishing methods
We publicise prosecution outcomes via:
- this website
- conferences and forums (our representatives participate in forums where they disseminate information and statistics on prosecutions)
We publicise administrative compliance outcomes via:
- this website
- the WorkCover Queensland Annual Report
- conferences and public forums (our representatives participate in forums where they disseminate information and statistics on administrative compliance outcomes, often with the purpose of educating customers and stakeholders about the legal requirement to hold workers’ compensation insurance)
More information
Find more information about accessing Departmental information on the Department of Justice and Attorney-General website.
If you are aware of any non-compliance with workers’ compensation laws, we encourage you to report it.
More information for insurers
Section 536 of the Act provides that once an insurer (or its third party claims manager or legal representatives) forms a reasonable belief that a person (potential defendant) has:
- committed fraud; and/or
- provided false information to the insurer and/or a registered person,
then the insurer must give the Workers' Compensation Prosecutions Unit (WCPU), Workers' Compensation Regulatory Services information in its possession which supports that reasonable belief without delay.
You must have facts or objective circumstances which provide tangible support that an offence has been committed. This does not mean an insurer must have proof beyond reasonable doubt prior to making a referral.
Some examples of where an insurer likely holds sufficient evidence to form a reasonable belief include:
- obtaining medical records which indicate a relevant pre-existing medical history which the worker has not disclosed to the insurer;
- obtaining a witness statement or surveillance which indicates that the worker may be exaggerating their symptoms and acting outside of their stated capacity;
- receiving information which confirms the worker returned to employment, self-employment or unpaid work/volunteering during their statutory claim and did not disclose this work to the insurer; and
- receiving a report from a registered person where the report indicates that the potential defendant has provided false and/or misleading information (i.e. information which could be said to be false and/or misleading due to conflicting evidence) to that registered person.
If you have sufficient information to support a reasonable belief of fraud, you must give WCPU all the information you have in relation to the claim without delay. Generally, this will include all relevant documents from both the statutory and damages claim files. If legal professional privilege is claimed over any of the documents, you should advise WCPU of this when making a referral.
You should not delay reporting pending the outcome of a procedural step in the process, such as a compulsory conference.
It is important to note that if a damages claim is settled and the insurer (or legal representative) settles the matter with knowledge or suspicion of the fraud, it is unlikely a prosecution will be able to proceed. A vital element of establishing fraud is proving that the insurer was deprived of the opportunity to make a decision based on all of the relevant facts and circumstances.
If a prosecution is commenced, the prosecution’s duty of disclosure is broad, ethical in nature and it is an obligation that is owed to the court. Defendants are entitled to know the case against them, so they can properly defend the charges they face. A defendant is entitled to know the evidence that will be presented in support of the charges and whether there is any other material which may be relevant to their defence, including material relating to the credibility or reliability of a prosecution witness. A failure to disclose relevant documents to the Workers’ Compensation Prosecutions Unit may result in a miscarriage of justice.
Generally, it will not prejudice a prosecution if the insurer advises the potential defendant that a referral has been made, especially where it appears the fraudulent behaviour is not ongoing.
Contact the Workers' Compensation Prosecutions Unit on wclegal@oir.qld.gov.au or (07) 3406 9927 if you require further information.