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04-02-2019-Brisbane

Date 4 February 2019
Charges 1 charge pursuant to Section 533 Workers’ Compensation and Rehabilitation Act 2003 (Qld) (WCRA) - Fraud

2 charges pursuant to Section 534(2) WCRA - false or misleading statements
Court Brisbane Magistrates Court
Plea Guilty
Case The worker exaggerated his symptoms and functional incapacity in order to prolong his workers’ compensation claim.
Facts

The worker lodged an application for compensation for a neck and back injury sustained at work on 6 April 2017. The claim was accepted by the insurer and the worker was paid compensation for the period 7 April to 11 July 2017 when the claim was ceased. Between April and early July 2017, the worker underwent various medical assessments and treatments. The worker continued to claim ongoing pain and incapacity associated with their work injury.

On 19 June 2017 the worker underwent an Independent Medical Examination conducted by an orthopaedic surgeon. During that assessment the worker made statements to the effect that all movements in their neck were limited due to pain.  Also, that their neck pain is aggravated merely by lifting a glass to their mouth and that as a result they were unable to pick up their children. The worker further stated that they avoid driving but can drive the few kilometres for physiotherapy. They also made statements to the effect that it was even painful when taking off their T-shirt and that neck pain increases when they bend to wash their legs. The doctor reported that during the examination the worker could walk on their heels and toes but made poor attempts to squat and on testing the range of movements in the shoulders the worker claimed to be unable to raise their arms in flexion or abduction above shoulder level due to neck pain. In his report, the doctor reported several abnormal clinical findings from the examination and complaints from the worker that were inconsistent with their claimed injury.

Unbeknown to the doctor, the insurer had arranged for the worker to be placed under covert surveillance at the time of the IME appointment and the immediately preceding days. The surveillance footage captured the worker’s ability to undertake various activities including carrying children and other objects using both arms, reaching and placing a child into a vehicle, driving a vehicle, removing their jacket uninhibited, walking and putting a backpack onto their shoulders and turning their head to the left and right side whilst smoking. On Dr McPhee’s evidence, these activities were inconsistent with the worker’s representations of their pain and incapacity to the doctor during the examination.

Penalty $3,500 fine
Restitution $4,553.98
Costs $7,852.20
Common Law rights extinguished? Yes
Conviction Not recorded
Consideration for Prevention A worker should not falsely represent their symptoms and incapacity to the insurer or to medical practitioners during their worker’s compensation claim.
Last updated
02 January 2020

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