Fraud­u­lent work­ers com­pen­sa­tion claims

Australasian Timber - - NEWS - By Stephen Booth and Lisa Qiu Cole­man Greig Lawyers The con­tent of this ar­ti­cle is in­tended to pro­vide a gen­eral guide to the sub­ject mat­ter. Spe­cial­ist ad­vice should be sought about your spe­cific cir­cum­stances.

EV­ERY EM­PLOYER in Aus­tralia is re­quired to hold an in­surance pol­icy which cov­ers their work­ers for in­juries at work. Most work­ers com­pen­sa­tion claims are gen­uine and le­git­i­mate, and this will gen­er­ally be ev­i­dent, es­pe­cially if the worker has suf­fered a phys­i­cal in­jury.

Some­times, em­ploy­ers will ques­tion whether the worker is gen­uinely suf­fer­ing from an in­jury, or at least an in­jury as se­ri­ous as is claimed, or if they’re just play­ing the sys­tem. Of course, nei­ther em­ploy­ers nor lawyers can sec­ond guess med­i­cal as­sess­ments. How­ever, that doesn’t mean that as an em­ployer, you just need to ac­cept each claim as it comes, with­out ques­tion. Your best course is to fully brief your in­surer and to be ac­tively in­volved in in­ves­ti­ga­tion and man­age­ment of the case, if you be­lieve there is no in­jury or that it is be­ing ex­ag­ger­ated.

It also doesn’t mean that em­ploy­ees who sub­mit fraud­u­lent work­ers com­pen­sa­tion claims al­ways get away with it.

Re­cently, in the case of R v Allred, the Supreme Court of the ACT im­pris­oned a worker for two years for sub­mit­ting a fraud­u­lent work­ers com­pen­sa­tion claim to Gov­ern­ment in­surer Com­care, or­der­ing the worker re­pay $64,418.62.

Mr Allred, an em­ployee of the ACT Am­bu­lance Ser­vice, in­jured his back on the job in 1991. He re­ceived fort­nightly pay­ments from Com­care for 20 years. In or­der to con­tinue re­ceiv­ing com­pen­sa­tion, Mr Allred had to sub­mit med­i­cal cer­tifi­cates to Com­care about once a year, demon­strat­ing that he was still suf­fer­ing from his in­jury and un­able to work.

How­ever, a Com­care in­ves­ti­ga­tion in­clud­ing sur­veil­lance and a Fed­eral Po­lice search of his home showed that he had in fact been self-em­ployed as a taxi driver from April 2007 to De­cem­ber 2010, earn­ing ap­prox­i­mately $120,000 a year, while still re­ceiv­ing ben­e­fits of about $72,000 each year. Had his in­come as a taxi driver been dis­closed to Com­care, he would only have been en­ti­tled to about $7,000 each year.

Mr Allred not only failed to dis­close the fact that he could work, and that he was re­ceiv­ing in­come other than his work­ers com­pen­sa­tion pay­ments, he also lied to Com­care by stat­ing that he wasn’t work­ing, was un­able to work, and wasn’t re­ceiv­ing any in­come out­side of his Com­care pay­ments.

The cus­to­dial sen­tence in this case serves as a strong re­minder that fraud­u­lent work­ers com­pen­sa­tion claims are not to be taken lightly.

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