15 May 2015
One charge 1 of fraud
Two charges of false or misleading information or documents
The worker lodged an application for compensation contending that he injured his lower back when lifting a box at work. A workers' compensation insurer accepted his claim and benefits were paid.
The worker was employed full-time by another employer for the entire period during which he received compensation.
Throughout his claim, the worker reported to both the insurer and health professionals that he was not working. He specifically denied working with the other employer. He also made false statements about his physical capacity.
The total amount of compensation paid during the offence period was $19,208.94.
Fraud charge: 6 months imprisonment (wholly suspended for 12 months)
False or misleading information or documents charges: 2 months imprisonment for each charge (wholly suspended for 12 months)
Workers' Compensation Regulator costs - $18,645.26
|Consideration for Prevention|
A worker should notify the insurer if they engage in a calling. That is, they should notify the insurer if they perform any activity giving rise to the receipt of remuneration or reward including 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 remuneration.
A worker should be honest about his/her symptoms and capacity to work when speaking to the insurer and/or medical practitioners. This includes the worker's capacity to perform work which is different to the work they were performing when they injured themselves.
If the worker believes they are able to engage in another calling (i.e. not the employment at which they injured themselves) then the worker should notify the insurer. If the insurer has a true understanding of the worker's capacity then they can properly manage the worker's claim.
It may be possible to arrange for the worker to engage in the alternate calling under a host employment arrangement. This allows the worker to perform the alternate calling while still receiving weekly benefits.
Alternatively, if the worker notifies the insurer that they intend to engage in an alternate calling then they may not be entitled to receive weekly benefits, but they might be entitled to receive compensation for medical and rehabilitation expenses.