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02-08-2019-Brisbane

Date 2 August 2019
Charges 1 charge pursuant to Section 533 Workers' Compensation and Rehabilitation Act 2003 (Qld) (WCRA) – Attempted Fraud
Court Brisbane Magistrates Court
Plea Guilty
Case The worker was charged with attempting to defraud the insurer by exaggerating their injuries in a Notice of Claim for Damages and making false representations to the doctors assessing their permanent impairment.
Facts

In November 2016 the worker submitted a workers' compensation claim for injuries to their foot. The claim was accepted, and the worker was paid compensation and medical expenses for their injuries.

The worker was assessed in February 2017 by an Orthopaedic Surgeon and the injury was determined to be an aggravation of a pre-existing condition. This was confirmed by a separate doctor in August 2017 where the workers permanent impairment was assessed at 0%. The worker was therefore not entitled to lump sum compensation payment.

The worker commenced a common law claim for damages and served on the insurer a Notice of Claim for Damages seeking over a million dollars in compensation. In this document the worker stated that they were limited to standing for 45 minutes due to pain, they were required to sit down all the time, that walking aggravates their symptoms and that they have to walk on their tip toes to relieve the symptoms.

The worker was assessed by two Orthopaedic Surgeons in late February 2018 in relation to the claim. To both, the worker reported high levels of pain between 7-10 out of 10. The doctors both noted that the worker was walking on their tip toes and that the heel was tender. One of these doctors assessed the worker with a total of 8% whole person impairment.

Surveillance footage was taken of the worker on 24 January 2018, 7 February 2018, 8 February 2018 and 10 April 2018. In this footage the worker is seen walking normally, shopping, driving and playing tenpin bowling.

This footage was sent to the doctors who had assessed the worker in February 2018, and they were both of the opinion that the footage was inconsistent with how the worker presented to them. One doctor was of the view that the worker had exaggerated her symptoms.

Penalty 4 months imprisonment, wholly suspended for an operational period of 18 months
Restitution N/A
Costs $8,930.16
Common Law rights extinguished? Yes
Conviction Recorded
Consideration for Prevention A worker should be honest about his/her symptoms andcapacity to work when speaking to the insurer and/or medical practitioners.