|Date||30 July 2018|
Charge 1 – Section 533 Workers' Compensation and Rehabilitation Act 2003 (WCRA) – Fraud
Charge 2 – Section 136 WCRA – failure to notify the insurer of an engagement in a calling within 10 days
Charges 3 to 9 – Section 534 WCRA – making false or misleading statements
One charge of attempted fraud and two charges of making false or misleading statements were discontinued.
|Court||Brisbane Magistrates Court|
|Plea||Plea of Guilty|
|Case||The worker was charged for failing to notify the insurer of an engagement in a calling and dishonestly providing false information to various doctors and the Workers' Compensation Review Unit and gaining benefits to which the worker was not entitled.|
The worker submitted an application for compensation with the insurer for a back injury they sustained at work. The claim was accepted and the insurer paid weekly compensation and medical expenses on the basis that the worker was totally incapacitated for work.
Throughout the claim, the worker continued to assert that they were completely unable to work.
In November 2014, the insurer received a tip-off from the employer that the worker was engaging in work at a pool manufacturing company as a sub-contractor. When confronted by the insurer, the worker initially denied having worked at the pool company however later admitted to this when they were made aware that fingerprint scans confirmed the worker had been onsite at the pool company.
The insurer subsequently ceased the worker's weekly compensation but continued to pay their medical expenses.
After the claim was ceased, the worker continued to claim to the insurer and to their treating doctors that they had been unable to work since their weekly compensation was ceased and they ultimately had the insurer's decision reviewed by the Workers' Compensation Regulator's Review Unit.
During that review process, the worker dishonestly withheld information that they had undertaken any other work between the insurer's decision in November 2014 to cease weekly payments and their application for review of that decision in July 2015.
As a result of the worker's false representations regarding their capacity for work, the insurer's decision to cease their weekly payments was overturned on review.
The matter was remitted to the insurer for consideration of partial incapacity payments and the worker was back paid compensation to cover the period when their weekly compensation was ceased.
In May 2016, the worker commenced a common law claim for damages against the insurer. During the common law claim, a number of invoices were provided to the insurer by the worker's lawyers for work the worker had engaged in as a furniture removalist between January and April 2015.
The worker had not disclosed that work during the review application process or when they received information that the review decision had been made in their favour and had therefore defrauded the insurer of weekly compensation payments.
The matter was listed for trial with the worker ultimately entering a plea of guilty to a number of charges, including fraud, before the commencement of the trial.
|Common Law rights extinguished?||Yes|
|Conviction||Conviction recorded on all charges|
|Consideration for Prevention|
The workers' compensation scheme provides benefits to workers who are legitimately unable to work.
A worker should not defraud the workers' compensation scheme by dishonestly claiming that they are incapacitated for work when they are able to work.