|15 March 2019
Charge One - Section 533 (via section 535) Workers' Compensation and Rehabilitation Act 2003 (Qld) (WCRA) - Fraud
Charge Two - Section 136 - Worker must notify return to work or engagement in a calling
Charge Three - Section 534(2) - False or misleading information or documents
Charge Four - Section 534(2) - False or misleading information or documents
Charge Five - Section 534(2) - False or misleading information or documents
Charge Six - Section 534(2) - False or misleading information or documents
|Gladstone Magistrates Court
|The worker was charged with engaging in a calling without notifying the workers' compensation insurer.
The worker lodged an application for compensation with WorkCover Queensland (the insurer) for a right shoulder injury sustained on 24 January 2017 while working as a casual roadhouse attendant.
On 3 February 2017, the insurer advised the worker of their obligation to advise them if they returned to work including voluntary work.
On 3 April 2017, the insurer received a tip-off that the worker was working at a local country club and that a witness had taken video footage of the worker working behind the bar.
On 4 April 2017, the insurer asked the worker if the worker was doing any volunteer work or the like and the worker replied they did help their friend's mum at the market.
On 7 April 2017, the insurer called the worker and reminded the worker of their obligation to declare any type of work completed, whether voluntary or paid. The worker was asked if the worker had participated in any work, paid or unpaid, since the beginning of the claim and the worker replied that they had not. The worker added the worker doesn't really call it work at the markets as the worker was just keeping their friend's mother company. The worker was again reminded that the worker was obliged to inform the insurer of any changes as required and the worker acknowledged they understood.
The insurer obtained surveillance footage of the worker working as a kitchen hand on 22 April 2017 at a country club.
On 24 April 2017, the insurer had a discussion with the worker about their referral to adjustment to injury counselling where the worker was also asked if they had gone out with friends on Friday or Saturday night. The worker responded that the worker had just stayed home and watched movies those nights.
Employment records obtained from the country club showed the worker had worked there from 27 March 2017 to 10 June 2017 and was paid a total of $2,409.12.
On 14 June 2017 the insurer called the worker regarding their employment at the country club and the worker admitted working there for approximately 2 months as a kitchen hand one day a week. The worker was asked why they did not disclose the work when given the opportunity on several occasions. The worker confirmed the worker knowingly did not tell the insurer as they did not want to get into trouble.
On 27 June 2017 the insurer issued the worker with an overpayment letter for $2,230.21 and the worker entered a repayment plan to pay back the monies owed. The worker made payments totalling $1,510.21.
The worker did not notify the insurer of their return to work within 10 business days as required by the Act and knowingly made dishonest representations to the insurer and registered persons during the claim.
s533 - three months imprisonment wholly suspended for 12 months for charge one (fraud)
s534 - one month wholly suspended for 12 months for each of charges three to six (false or misleading information) All terms to be served concurrently
s136 - convicted but not further punished in relation to charge two (failing to notify the insurer of return to work)
|$5,421.44 - Workers Compensation Regulators Costs
|Common Law rights extinguished?
|Consideration for Prevention
A worker should notify the insurer if they perform any activity giving rise to the receipt of remuneration or reward including employment, self-employment or the performance of an occupation, trade, profession, or carrying on of a business, whether or not the person performing the activity received
A worker should be honest about his/her symptoms and capacity to work when speaking to the insurer and/or medical practitioners.