21 May 2015
One charge of fraud
Four charges of false or misleading information or documents (One charge later withdrawn)
One charge of the worker failing to notify return to work or engagement in a calling
The worker allegedly sustained various injuries when he fell 12 metres from a tree while employed as a tree faller/arborist.
The worker lodged an application for compensation with the insurer and was paid compensation. A notice of claim for damages was served on the insurer.
During the period that the worker was receiving compensation he undertook casual paid work. The worker issued a number of invoices for work conducted during the statutory claim. The worker did not notify the insurer of his engagement in a calling as required by section 136 of the Workers' Compensation and Rehabilitation Act 2003.
The worker made false or misleading representations to the insurer and medical providers to the effect that this employment was conducted in a voluntary capacity and was unpaid.During this period, the insurer provided the worker with remittance advices which advised the worker of his obligation to report any engagement in paid or unpaid employment. The insurer also advised the worker of this obligation during telephone conversations and in email correspondence.
The total amount of compensation paid during the offence period was $6,885.91 (i.e. this was the “amount of the fraud”).
Workers' Compensation Regulator costs - $5,000.00
|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.