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22-10-2019-Townsville

Date 22 October 2019
Charges

1 charge pursuant to Section 533 Workers' Compensation and Rehabilitation Act 2003 (Qld) (WCRA) – Fraud
1 charge pursuant to Section 533 WCRA – Attempted Fraud
6 charges pursuant to Section 534 WCRA – Providing false or misleading information or statement

Court Townsville Magistrates Court
Plea Guilty
Case The worker was charged with defrauding the insurer by failing to disclose relevant pre-existing injuries and for providing false and misleading information to medical practitioners and insurer staff. The worker further attempted to defraud the insurer in failing to disclose same in his Notice of Claim for common law damages and making false and misleading statements to doctors assessing his permanent impairment.
Facts

A claim was lodged with WorkCover Queensland (WorkCover) which alleged a workplace injury to a worker's knee. It was approved and the worker underwent surgery. Throughout the course of the claim the worker expressly denied the existence of a relevant medical history; twice to WorkCover and on two further occasions to medical practitioners. WorkCover paid his medical expenses and wages for a period of approximately 13 months. The total compensation paid by WorkCover under the worker's claim was $53,382.33.

In addition, the worker lodged a common law claim for damages in the amount of $614,818.53. In the course of that claim they also denied the extent of their relevant prior history to two additional medical practitioners however did not receive any payments.

The worker had a history of knee injuries which resulted in multiple surgeries and pre-existing symptomology and they denied or failed to volunteer that history or only provided partial disclosures. The denial of these material particulars had the result that WorkCover suffered a detriment as it was deprived of the opportunity to investigate those pre-existing conditions and consequently promptly approved the worker's claim.

Penalty

18 months imprisonment, wholly suspended for an operational period of 2 years on the fraud charge

6 months imprisonment, wholly suspended for an operational period of 2 years on each of the other charges

Terms to be served concurrently

Restitution $53,382.33
Costs $44,088.74
Common Law rights extinguished? Yes
Conviction Recorded
Consideration for Prevention A worker should be honest about any prior injuries which they suffered.