22 May 2015
One charge of fraud
Two charges of false or misleading information or documents
One charge of the worker failing to notify return to work or engagement in a calling
The worker lodged an application for compensation with a workers' compensation insurer in relation to an injury she allegedly sustained at work. The claim was accepted and compensation paid .
During the period of compensation the worker engaged in a calling as a kitchen hand and waitress. 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 her general practitioner to the effect that she was unable to undertake any form of work .
The total amount of compensation paid from the start of the offence period was $67,486.13.
Fraud charge: 15 months imprisonment (wholly suspended for 2 years)
False or misleading information or documents charge: 6 months imprisonment for each charge (wholly suspended for 12 months)
Failure to notify of engagement in a calling charge: Convicted but not further punished
Workers' Compensation Regulator costs - $6,378.10
|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.