Employee / injured worker fraud

If an injured worker is receiving benefits they must, by law, advise their employer's Agent or Insurer, if they are doing any paid work or commence operating their own business.

An employee who fabricates an injury is also acting fraudulently.

Examples of employee or injured worker fraud:

• injury didn't occur at work or whilst travelling to or from work.
• failure to notify return to work or change in income.
• non-disclosure of multiple claims relating to the same injury.
• false or overstated travel and/or expense claims.
• falsifying WorkCover medical certificates.
• supplying false or misleading information in relation to a claim.

Fraud Indicators:

• The worker's descriptions of the incident conflicts with medical findings or the circumstances described do not fit the type of injury received.
• The worker delays reporting the claim without reasonable explanation.
• Excessive mileage travelled to and from medical appointments.

NB: On their own, fraud indicators do not conclusively establish the existence of fraud. Further investigation is required to determine if fraud does exist.