25-11-2021 Brisbane

Charge 1 – Section 533 Workers’ Compensation and Rehabilitation Act 2003 (WCRA) – Attempted Fraud

Charges 2 - 3 – Section 534 WCRA – making false or misleading statements

The worker was charged with attempting to defraud the insurer by failing to disclose self-employment they were undertaking to the insurer and to their medical practitioners.

The worker suffered a lower back exacerbation while employed as a Carpenter where they were required to manually handle panels weighing approximately 20kg each.

On 25 July 2017, the worker lodged an application for workers’ compensation with the insurer, which was accepted on 7 August 2017, after the worker’s injury was assessed as being a symptomatic exacerbation.

On 5 October 2017, the worker was reassessed by an Orthopaedic Surgeon who had previously assessed the worker as having a symptomatic exacerbation. The surgeon opined that the worker’s aggravation of multi-level spondylosis was stable and stationary and assessed the worker as having 0% permanent impairment. Given this, the worker’s claim was ceased on 8 October 2017 and no lump sum offer was made.

On 25 November 2019, the insurer received a Notice of Claim for Damages signed on that day by the worker’s lawyer, on the worker’s behalf. This Notice of Claim stated that the worker experiences ongoing pain in their lower back and suffers extensive functional limitations. The Notice of Claim stated that the worker had lost income and the capacity to earn income in the future is diminished. It also noted that the worker had been actively seeking employment but had been largely unsuccessful and that they were currently unemployed and struggling to find suitable employment due to their injuries.

During the common law claim, the insurer’s lawyers, discovered that the worker had an Instagram page which suggested the worker was undertaking self-employment activities.

Further investigations confirmed that the worker was making and selling surfboards through a surfboard shop from 6 November 2017 to 30 December 2019. The worker sold 37 surfboards and a total amount of $31,725.25 was paid to the worker. This income was not disclosed to WorkCover.

The worker entered a plea of not guilty and the matter proceeded to trial in August 2021. The worker was subsequently found guilty on 25 November 2021.

9 months imprisonment, wholly suspended for an operational period of 18 months on the attempted fraud charge

6 months imprisonment, wholly suspended for an operational period of 18 months for the providing false or misleading information charges

Terms to be served concurrently.

$0

A worker should be truthful about their working status to their medical practitioner and to the insurer.