Do Employers have Evidence of Fraud?

In workers’ compensation claims in Queensland, it is an offence for injured workers to make false and misleading statements.

Pursuant to the Workers’ Compensation and Rehabilitation Act 2003, a person must not in any way defraud or attempt to defraud a workers’ compensation insurer. That means an injured worker must not provide false or misleading statements to WorkCover, a self-insurer, the Workers’ Compensation Regulator, or a doctor or Allied Health Professional who provides medical treatment.

If an Employer reasonably believes that an injured worker is defrauding or attempting to defraud WorkCover or a self-insurer, the Employer must “without delay” pass on relevant information to WorkCover or the Regulator for investigation.

If the investigation leads to a criminal prosecution, and the injured worker is found guilty, penalties may include fines or jail. Further, the injured worker may lose their right to claim damages for their injury.

It is not uncommon for us to receive tip-offs from Employers derived from social media or heard “on the grapevine” from co-workers.

Whilst mere rumours may be unhelpful, action should be taken where possible to verify such allegations.

WorkCover and WorkCover’s solicitors will do what they can to investigate allegations of fraud although the ultimate decision on whether to prosecute lies with the Worker’s Compensation Regulator.

If an Employer has a suspicion of fraudulent conduct by an injured worker, it is necessary to cooperate with WorkCover and their lawyers to take the appropriate steps indicated under the Workers’ Compensation legislation.

“The content of this publication is for reference purposes only. It is current at the date of publication. This content does not constitute legal advice and should not be relied upon as such. Legal advice about your specific circumstances should always be obtained before taking any action based on this publication.”
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