13-03-2018-Townsville

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

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.

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.

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.