All referrals* received by the Fraud Investigation Branch are reviewed and if deemed appropriate allocated for further investigation.  The review, assessment and investigation process is:

• Referral* is received or suspected fraud identified through  WorkCover Authority.
• Further factual and background information is gathered.
• The referral and further information examined by an assessment committee.  
• If there is an indication that an offence may have been committed the matter is allocated for investigation.  
• Investigations are completed by WorkCover Investigators and may also be outsourced to private investigation companies. 
• Investigation techniques include the taking of witness statements, surveillance, issuing of notices to obtain documents and other evidence and the execution of search warrants.
• In some instances where insufficient evidence is uncovered to criminally prosecute a matter in court, costs maybe able to be recovered through civil action.   
• Where there is sufficient evidence to prosecute, the matter will be submitted to WorkCover’s Legal Group.  See Prosecution page.

*  A 'referral' means a complaint or ‘tip off’.  Any person can refer a matter to WorkCover including an employer, injured worker, or member of the public.

Examples of the types of matters investigated by WorkCover’s Fraud Investigation Branch:

• An injured worker on weekly benefits fails to notify the Agent or employer of commencement of other employment.
• A sub-contractor supplies a company with a falsified certificate of currency.
• An employer fails to pass on workers compensation benefits to an injured worker.
• A medical practitioner invoices for a consultation that did not take place.
• An injured worker submits an altered medical certificate.

NB: in some instances whilst the activities of a person may be highly suspicious and it may appear that they are defrauding the system, there may be insufficient admissible evidence to prosecute.