21-03-2023 Brisbane

Charge 1 – Section 533 WCRA – Fraud
Charge 2 – Section 533 WCRA – Attempted fraud

The worker failed to disclose a relevant pre-existing injury.

On 3 December 2018, the worker attended their General Practitioner complaining of right knee pain. The worker was observed to have bruising and swelling to their right knee. The worker was prescribed medication, referred for radiological imaging and provided a medical certificate for two days.

On 13 February 2019, the worker made a claim to WorkCover Queensland for an injury and said they was sustained to their right knee on 5 February 2019 during their employment.

In the worker’s application for compensation, they agreed to a statement which required them to acknowledge that it is an offence against the WCRA to make a statement that is false or misleading and that the information they had provided was true and not misleading.

In the application for compensation, the worker denied having previously suffered any similar injuries or conditions. The worker also reiterated this statement to a WorkCover Claims Representative via telephone on 18 February 2019.

On 19 February, WorkCover accepted the worker’s claim for a right knee injury and commenced paying applicable benefits.

Over the course of the statutory claim, the defendant made dishonest statements to four orthopaedic specialists about having no previous symptoms or injuries to their right knee.

At no point during the worker’s claim did they disclose to WorkCover or any of the associated medical practitioners that they had sustained any prior injury, symptoms or impairment to their right knee.

The worker received $108,398.58 in compensation as a result of their conduct.

On 29 June 2019, the worker signed a Notice of Claim for Damages for their right knee injury which was served on WorkCover. The worker sought $798,834.05 in damages.

In the Notice of Claim, the worker swore a declaration that required them to agree that the information contained in the notice was true and not misleading. The worker also swore that they had not omitted any information which would make the information provided in that document false or misleading.

Within the Notice of Claim, the worker disclosed they had attended their General Practitioner in relation to right knee swelling. However, the worker dishonestly omitted critical information regarding their prior right knee injury which included: that they suffered bruising to the knee; the date of the consultation; the radiological investigations that were recommended; that medication was prescribed; and that they was provided with a medical certificate for the injury.

Charge 1 – Section 533 WCRA – Fraud:

• 2 years imprisonment wholly suspended.

Charge 2 – Section 533 WCRA – Attempted fraud:

• 2 years imprisonment wholly suspended.

A worker must be honest about their relevant medical history in their dealings with the insurer and medical providers associated with their workers’ compensation claim.