18 December 2014
One charge of fraud
One charge of False or misleading information or documents
Matter dealt with ex parte (in the worker's absence)
The worker allegedly sustained a whiplash neck injury when the vehicle he was travelling in hit a tree. This incident occurred while he was working for Company A. The worker applied for compensation with a workers' compensation insurer (the Company A claim). The Company A claim was accepted and the insurer paid the worker compensation.
The worker lodged a new claim for compensation relating to a back, hip and leg injury. The worker sustained this injury while he was working for Company B.
The injury for the Company B claim fell within the period the worker was certified as totally incapacitated and receiving compensation under the Company A claim. Inquiries with Company B revealed the worker had been doing casual work with them for the period he was receiving workers' compensation.
The total amount of compensation paid during the offence period was $7,450.60.
Workers' Compensation Regulator costs - $5,773.75
|Consideration for Prevention
A worker should notify the insurer if they continue to work in their second job. 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.