Workers’ compensation fraud
Impacts of fraud within the scheme
Workers’ compensation fraud poses an unacceptable risk to the integrity and viability of the scheme and impacts both employers and workers. The costs of undetected fraud and related offending by workers and service providers are borne by employers through increased premiums. Additionally, offending by uninsured or underinsured employers’ impacts their workers and unfairly penalises businesses that comply with their obligations.
Under the Workers’ Compensation and Rehabilitation Act 2003 (Act), it is an offence for a person to:
- defraud or attempt to defraud an insurer (section 533), or
- state anything, or give a document containing information, to the Workers’ Compensation Regulator (Regulator), WorkCover Queensland, self-insurer or a registered person that the person knows is false or misleading in a material particular (section 534).
Workers’ Compensation Fraud Taskforce
The Workers’ Compensation Fraud Taskforce (Taskforce) has been established between the Office of Industrial Relations and WorkCover Queensland to investigate ways to identify, coordinate, support and oversee the implementation of initiatives to improve strategic and operational responses to fraud and related offending in the scheme.
The key deliverable of the Taskforce is the development and delivery of a Fraud Action Plan to better prevent, detect and respond to fraud.
Fraud and other offending – investigations and prosecutions
The Regulator actively investigates and prosecutes workers, employers and providers who defraud the scheme. In 2024-25, the Regulator investigated 164 suspected fraud cases and initiated six prosecutions.
Since 1 July 2025, nine prosecutions have commenced and six prosecutions have been successfully finalised, four against workers for fraud and two against employers for providing false information. All four workers were sentenced to imprisonment, and the employers were collectively fined $98,500.
Investigation outcomes for the period 1 July 2025 and 31 December 2025:
- 69 reports of suspected offending were received (58 reports related to suspected fraud)
- 41 investigations were finalised
- 14 warning letters were issued
- eight matters were referred for consideration for potential prosecution.
Prosecution outcomes
Man jailed for defrauding WorkCover
On 29 August 2025, a Maroochydore man was jailed for six months for defrauding WorkCover. He started and ran a real estate agency while receiving workers’ compensation on the basis he was unfit for work. There was evidence of sustained and deliberate deception for more than a year, involving repeated lies to doctors, WorkCover staff, and the Medical Assessment Tribunal that he was unable to work. He was ordered to pay WorkCover back the $117,387.22 he fraudulently obtained.
Youth worker jailed for workers compensation and Centrelink fraud
On 4 September 2025, a youth worker in Mount Isa was sentenced for defrauding WorkCover. She claimed she was unable to work due to a psychological injury while secretly working for two other employers. She was sentenced to serve four months in custody, and she was also ordered to pay WorkCover back the $36,000 she fraudulently obtained.
Company director sentenced to nine months imprisonment for attempting to defraud WorkCover
On 25 November 2025, a company director in Hervey Bay was sentenced for attempting to defraud WorkCover. He was not a “worker” within the meaning of the legislation and provided false payslips and bank records to satisfy WorkCover that he was entitled to compensation. He was sentenced to nine months imprisonment, narrowly avoiding actual custody.
Worker serving jail sentence for falsifying medical certificates, claiming for reimbursement and pretending to be a physiotherapist
On 25 February 2026, a worker was sentenced for defrauding WorkCover. He pretended to be a physiotherapist and provided treatment updates to WorkCover to extend his claim. He also fraudulently claimed reimbursement for travel and other expenses and provided false medical certificates to the insurer. He will serve three months of his 12-month sentence in custody and was also ordered to pay WorkCover back the $11,410.48 he fraudulently obtained.