17 August 2016
One charge of fraud
Five charges of providing false or misleading information
Townsville Magistrate Court
The worker lodged an application for compensation with the insurer for injuries to his left shoulder he allegedly sustained at work.
Medical records were obtained showing the worker had attended a medical centre on the day before the alleged work injury. The doctor's notes recorded that the worker had come off his scooter a few days earlier and hurt his left shoulder. The doctor noted limited movements, especially abduction and external rotation. The doctor referred him for an x-ray and ultra-sound. The worker did not follow through with the referral.
Throughout the period of the statutory claim, the worker made dishonest representations to the self-insurer and registered persons about his prior left shoulder injury. The worker either failed to disclose the previous shoulder injury or denied having a prior shoulder injury.
The worker also exaggerated the symptoms of his injury to the insurer and registered persons. During the statutory claim the insurer obtained surveillance of the worker. The activities the worker was seen doing in the surveillance were inconsistent with the worker's representations to the insurer and registered persons regarding his physical capacity.
The total amount of compensation paid during the offence period was $110,147.89.
Charge 1 (Fraud): 12 months imprisonment
Charges 2 - 6 (Providing False or misleading information): 4 months imprisonment for each charge
To be served concurrently with immediate parole.
$16,333.68 - Workers Compensation Regulators Costs
|Consideration for Prevention
A worker should be honest about whether they injured themselves at work or outside of work and about his/her symptoms and capacity to work when speaking to the insurer and/or medical practitioners.