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
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
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.
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An employee that refused a reasonable offer of settlement was ordered by the FWC to pay his ex-employer's legal costs.
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