WorkCover fraud leads to five months imprisonment

A Queensland man, who defrauded nearly $78,000 from WorkCover Queensland, will be sent to prison for five months and has been ordered to repay the money.

Magistrate Joseph Pinder found the offending was serious, intentional, sophisticated and considered, when sentencing the defendant in the Brisbane Magistrates Court this month.

The defendant sustained a right arm injury at work in late April 2018. A claim was lodged and accepted by the insurer on 28 May 2018.

From 12 June 2018, the defendant was certified fit to return to suitable duties at work and started working for a host employer from August 2018, with wages paid by the insurer.

Then, in February 2019, the defendant started working in paid employment with another employer and did not tell the insurer. He arranged for his wages to be paid into his wife’s bank account.

On three separate occasions after he started working, the defendant gave the insurer false timesheets purporting to be for work completed at the host employer. On 26 April 2019, the defendant told a specialist doctor that he was working in the host employment program. On this basis, the insurer continued to pay him weekly compensation.

When speaking with the insurer in May 2019, the defendant said that he had been looking for work, but it was hard because he still did not have full clearance. On 7 June 2019, the defendant again represented to the insurer that he was looking for employment but was worried about his symptoms preventing him from working.

The defendant was medically cleared for his pre-injury duties on 4 July 2019. The following day, he told the insurer that it looked like he had a job and confirmed in October 2019 that he had recently started a new job.

Following the closure of his claim, the defendant sought a permanent impairment assessment for the purpose of obtaining lump sum compensation. He didn't tell the assessing doctor that he had been working during his claim. On 8 January 2020, the defendant accepted the lump sum compensation offered.

He earnt over $48,000 at his undisclosed job over a period of about five months during the statutory claim. The quantum of the fraud was $77,968.75.

The Workers' Compensation Regulator argued that the defendant's offending was financially motivated. The offending occurred over a period of 11 months and was sophisticated and calculated, given the defendant provided false time sheets and sought to be paid into his wife's bank account to cover up the work so he could continue to “double dip” for an extended period.

Magistrate Pinder took into consideration the early plea of guilty, lack of criminal history, and remorse when sentencing the defendant to 15 months’ imprisonment suspended after five months.

Quotes attributable to Workers’ Compensation Regulatory Services Executive Director Janene Hillhouse

Workers' Compensation Regulatory Services Executive Director Janene Hillhouse said "We do not hesitate to take legal action when workers' compensation laws are broken".

"Prosecutions serve as a strong deterrent against potential offenders and help to preserve the integrity of the workers' compensation scheme.

"Our purpose is to maintain a fair and efficient workers' compensation scheme that balances the needs of workers and employers".

Media contact: 0478 33 22 00 or oirmedia@oir.qld.gov.au.