|16 August 2022
|Richlands Murri Court – Magistrate Previtera
|Guilty to five charges
The worker defrauded the insurer by failing to notify of his engagement in a calling by not disclosing to the insurer that he had commenced paid employment during the claim period.
The worker knowingly made false or misleading statements by lying about his capacity for work and work status during assessments with medical professionals and with the insurer.
The worker sustained a serious foot fracture while working as a labourer. He applied for compensation with the insurer. This was accepted and warnings about providing false or misleading information and failing to notify of engagement in a calling were provided.
In the year following the worker’s injury, the insurer funded several surgeries to repair the damage to the worker’s foot. During this time, the worker varied from being fit for suitable duties to being unfit for any work.
The worker attended an orthopaedic surgeon engaged by the insurer and reported that he had been totally off work for all occupations since the injury. The worker also told the insurer he was scared about returning to work and being re-injured.
The worker reported to a general practitioner that he was seeking assessment for total and permanent disability. The doctor contacted the insurer as he was concerned by the worker’s lack of compliance. The insurer arranged for surveillance to be conducted on the worker, which revealed he had been employed as a labourer.
The insurer confronted the worker in relation to his work as a labourer and the worker admitted that he had returned to work and had not notified the insurer. The worker apologised for being dishonest and agreed to repay the overpaid compensation.
Further investigations revealed that during the period the worker had commenced work as a labourer, he had been certified totally unfit for work.
|Common Law rights extinguished?
|Consideration for Prevention
Workers must be honest about returning to any work during their claim, and their capacity for work.