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13-03-2018-Townsville

Date 13 March 2018
Charges

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

Charge 2 – Section 534(2) WCRA – False or misleading information or  document

Charge 3 – Section 533 - WCRA – Attempted fraud
Court Townsville Magistrates Court
PleaPlea of guilty to all charges
Case The worker was charged for failing to notify the insurer of his engagement in a calling, and thereby gaining benefits to which he was not entitled.
Facts

The worker suffered a psychological injury after witnessing a workplace  death on 20 February 2015. On or about 5 March 2015, he lodged an Application  for Compensation with the insurer seeking compensation payments in respect of an  injury to his psychological system in general, and an anxiety/stress disorder.  The application form contained an ‘Applicant’s statement’ which required the  worker to agree to advise the insurer if his circumstances change and in  particular, to advise the insurer if his employment status changes during the  currency of his claim.

The worker’s claim was accepted and he was initially paid workers’ compensation in the form of  compensation, medical treatment and expenses from 5 March 2015 to 10  July 2015.

On 1 September 2015 the worker contacted the insurer and confirmed he  had been “let go” from his job. The worker was then paid compensation from 10  September 2015 to 6 June 2016. He received a ‘remittance notice’ with each  weekly payment which outlined the amount of compensation paid to him. The  notice also included a warning that he must notify the insurer immediately if  he did any work while receiving compensation; whether it be paid or unpaid  work, or on a full-time, part-time or casual basis.

On 9 March 2016, the worker was employed on a casual basis as  a groundsman/ truck driver. He did not notify the insurer of his  engagement in a calling within 10 business days as required by s 136 of the  Act.

On 12 September 2016, the worker signed a Notice of Claim for  damages and caused it to be served on the insurer. In the Notice of Claim, The  worker stated that he was not currently undertaking any employment on a paid or  unpaid basis; and that his sole source of income for the 2015-2016 financial  year was his workers’ compensation benefits.

On 15 November 2016, The worker attended a consultation with  a psychiatrist at the request of the insurer for the purpose of an independent  medical examination. During the consultation, the worker advised the  psychiatrist that he was not working, and since his injury and he had been  socially isolated and only left his house about three times per week.

Throughout the period of the claim, the worker did not  disclose his work to the insurer, his General Practitioner or during his  psychiatrist appointment.

Around 16 January  2017 the fraud came to light during investigations regarding the worker’s  common law claim for damages.

Penalty

Sentenced to 9  months imprisonment for the fraud charge, 1 month for the false and misleading  charge and 6 months for the attempted fraud charge.

The sentence was wholly suspended for a period of 2  years.

Restitution $6,520.30
Costs $13,914.63
Common Law rights extinguished? Yes
ConvictionRecorded
Consideration for Prevention

A worker should  notify the insurer if they continue to work in their second job.

A worker should notify the insurer if they perform any  activity giving rise to the receipt of remuneration or reward including  self-employment or the performance of an occupation, trade, profession, or  carrying on of a business, whether or not the person performing the activity  received remuneration.

Last updated
26 June 2018

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