05 December 2014
One charge 1 of fraud
The worker plead not-guilty and the matter was set down for trial. The worker changed her plea to guilty on the morning of the first day of the trial.
An application for compensation was lodged with a workers compensation insurer for an injury the worker allegedly suffered at work.
The insurer accepted the claim for a 'twisted left knee' and paid benefits to and on behalf of the worker.
The insurer obtained surveillance of the worker while she was receiving workers' compensation.
The surveillance showed that representations the worker had made to the insurer and medical providers about her physical abilities and limitations were false or misleading.
The medical providers were given copies of the video footage. The orthopaedic surgeon opined that the level of activity demonstrated in the surveillance was not consistent with the symptoms or level of activity the worker reported to him. The exercise physiologist reported that the worker was observed in the surveillance footage to perform tasks with physical demands in excess of those demonstrated during his assessment of the worker and was not observed to exhibit any of the same pain behaviours.
The total amount of compensation paid during the offence period was $11,156.89 (i.e. this was the "amount of the fraud").
Workers' Compensation Regulator costs - $3,000.00
|Consideration for Prevention
When speaking to the insurer and/or medical practitioners, a worker should always be honest about their symptoms and restrictions as a result of the work injury, as well as their capacity to work.