22-01-2018-Brisbane

Charge 1 – Section 533 Workers' Compensation and Rehabilitation Act 2003 (Qld) (WCRA) – Fraud

5 charges of making false or misleading statements pursuant to section 534 of the Act were discontinued.

The worker made a claim for workers' compensation with the insurer related to a motor vehicle accident the worker was involved in on their way to work. The claim was accepted on 10 June 2016.

During the claim, the worker's return to suitable duties was pushed back a couple of times due to the worker's complaints about being unable to return to work as the worker alleged they were unable to drive. The worker alleged that they had difficulty driving as they had developed anxiety and fear of leaving the house from the accident. The worker report psychological issues with driving, taking a cab or public transport, making it difficult for her to return to work.

The worker commenced seeking treatment from a psychiatrist and was diagnosed with mixed anxiety and depressed mood, further complicated by panic attacks and agoraphobia.

The worker failed to attend a number of medical appointments throughout the claim as they reported that she could not be in a car on a highway and could not use public transport. The worker's issues around being in a car, and attempts to return to work continued throughout the claim and they made numerous representations to medical practitioners and the insurer that can be substantiated by the evidence as false and misleading.

Hire car records showed that that the worker drove 696 kilometres between 12 and 29 July 2016 during which time the worker had been stating that they were unable to get to work and had to change physiotherapists due to driving issues.

Surveillance footage obtained in December 2016 and January 2017 showed that the worker had grossly exaggerated their incapacity and symptoms particularly in relation to capacity to drive and return to work.

There was sufficient evidence to prove that the worker obtained compensation that they were not entitled to due to dishonesty in exaggerating their psychological condition. This dishonesty misled the insurer about the worker's true capacity and deprived them of that information in assessing their ongoing claim.