WorkCover is a taxpayer funded, government run insurer. A person can claim WorkCover if the person has suffered an injury at, or because of, work and due to that injury, the person must take time off work or can only work at reduced capacity. The injured person can then claim compensation to help keep them financially secure, while also working towards rehabilitation and getting back to work.
The law governing the WorkCover rules is the Workers’ Compensation and Rehabilitation Act 2003.
A person must be entirely honest in their dealings with WorkCover. It is an offence to falsely claim an injury, or continue to work at full capacity while receiving Workcover payments or not to inform Workcover if the person returns to work while still receiving payments.
How offences are detected
Offences under the Workcover legislation are detected by direct investigations. For example, investigators appointed by Workcover may shadow a claimant to make sure he is not continuing to work despite receiving compensation. The investigation may involve confirming or assessing the extent of claimed injuries, so if a roofer claims he has injured his back such that he is unable to work on the top of a roof, the investigator may covertly follow him to make sure he is not working on any roofs. The investigator has the power to require a person to give information or documents relevant to an investigation (such as bank records).
Offences
A person who misleads Workcover about the extent she is working or the extent of her injuries, and simultaneously receives compensation or has a claim for compensation pending, commits an offence.
The two offences under the Act with the highest maximum penalties are fraud and providing false or misleading information. These are section 533 and 534 respectively.
Penalties
Section 533 makes it an offence to defraud, or attempt to defraud, Workcover. The penalty is a maximum fine of $71,875 or maximum imprisonment of 5 years.
Section 534 makes it an offence provide false or misleading information or documents to Workcover. The penalty for this is a maximum fine of $21,577 or a maximum of 1 year imprisonment.
Usual Penalties
The two main offences under the Workers’ Compensation and Rehabilitation Act 2003 are generally punished firmly. The penalty will normally be harsher the higher the amount defrauded or attempted to be defrauded. The usual penalty will be imprisonment, whether some actual imprisonment or a period of wholly suspended imprisonment. For a useful summary of case outcomes can be found here.
Possible Defences
For a fraud offence, all Workcover must establish is a worker who is receiving compensation engaged in work and did not notify Workcover or, to establish attempted fraud, the person lodged an application for compensation, engaged in work, and did not notify Workcover (before receiving compensation). This is easily established if someone earns money while receiving Workcover compensation. Usually, to successfully defend a charge of Workcover fraud, defence would have to show how, despite Workcover’s evidence, the defendant did not earn money while receiving Workcover compensation, or if she did so, it was a genuine mistake. Given Workcover will require the defendant to sign a document undertaking to inform Workcover of any change of circumstances, and will provide the defendant documents stressing the importance of reporting any changes in circumstances (i.e. improvements in injuries, starting a new job etc), a defence of mistake would require a high bar to succeed.
Can Clarity Law Help Me?
We have experience in assisting with these types of cases. For the last case we had, we were able to reduce the alleged fraud by thousands of dollars, and we reduced the time period the client was alleged to have worked for while receiving compensation by months. We were able to do this by careful case analysis and negotiations with the prosecutors. However, these types of cases are time consuming and can be complicated, so we highly recommend you engage experienced private lawyers (such as us) to assist.
Conclusion
This article is by no means a complete guide to Workcover prosecutions, but we trust it serves as a useful introduction. If you are charged by Workcover, or are requested to give an interview, please contact our office for a free initial consultation.
How do I get more information or engage Clarity Law to act for me?
If you want to engage us or just need further information or advice then you can either;
- Use our contact form and we will contact you by email or phone at a time that suits you
- Visit our website at www.claritylaw.com.au
- Call us on 1300 952 255 seven days a week, 7am to 7pm
- Email This email address is being protected from spambots. You need JavaScript enabled to view it.
