24-02-2021-Southport

• Charge 1 (Southport Complaint) – Section 533 Workers’ Compensation and Rehabilitation Act 2003 (WCRA) – Fraud
• Charges 2 to 6 (Southport Complaint) – Section 534 WCRA – making false or misleading statements
• Charges 1 (Brisbane Complaint) – Section 534 WCRA – making false or misleading statement

On 12 April 2019, the worker sustained a soft tissue knee injury in the course of their employment. The worker lodged a claim for compensation which was accepted.

Throughout the course of the claim, the worker maintained that they had ongoing pain and restricted movement. On three occasions, the worker told the insurer that their injury hadn’t improved, the prescribed treatment didn’t really work, their knee was still swollen and they haven’t been able to put much weight on their knee.

After information was received that the worker was playing a physical contact sport, the insurer questioned them about their involvement. During this conversation, the worker denied they were undertaking this sport and said they did no physical activity at all, including housework.

The worker said they could not jump or run at all. The worker reiterated this to two medical practitioners, telling them only that they had participated in some training for this sport but that they weren’t able to play due to their injury.

Information from a sporting club was received which confirmed that the worker participated in nine games throughout the course of their compensation claim and was seen wearing a knee brace paid for by the insurer while playing.

6 months imprisonment, wholly suspended for an operational period of 18 months on all charges

Terms to be served concurrently

A worker should be truthful to the insurer and medical practitioners about the extent of their capacity and ongoing symptoms.