Employer > Contacts/Other useful information > Fraud and investigation

Fraud and investigation

Fraud is investigated by WorkCover's Investigations and Recoveries Unit. WorkCover takes fraud very seriously and thoroughly investigates allegations to protect the integrity of the Scheme and people’s confidence in it. If fraud is found to have occurred, the person who carried out the fraud may be prosecuted – amongst other outcomes.

WorkCover is required to investigate all allegations of fraud and non-compliance with the Act. This is particularly important because fraud and non-compliance costs employers through higher workers compensation levies. Fraud can be committed by workers, employers and/or providers.

NOTE: if a worker injures themselves at work and there is no witness to the injury an employer may think that the claim is fraudulent. In most cases, this is incorrect and all it does is cast doubt and suspicion on the worker hampering the return to work process.

Report fraud

If you suspect someone of committing fraud against the Scheme, please contact the Investigations and Recoveries Unit. You can remain anonymous if you wish.

WorkCover Investigations and Recoveries Unit
Phone: 13 18 55
Email: investigationunit@workcover.com

Fill out the Fraud allegation form

Examples of fraud

Examples of worker fraud

  • A claim for an injury that does not exist
  • Exaggerating an injury
  • A claim for an injury that is not related to employment
  • A claim for weekly payments while earning wages
  • Altering medical certificates to obtain weekly payments
  • Knowingly providing false information for a claim

Examples of employer non-compliance and fraud - registration and levy

  • Failing to register as an employer
  • Providing false or misleading information at the time of registering
  • Failing to submit returns in the nominated time frames
  • Providing false or misleading information regarding remuneration paid during a financial year
  • Providing false information for the purpose of evading levy payments.

Examples of employer fraud and non-compliance - claims

  • Claiming more than you are entitled to for weekly payments reimbursement
  • Overstating income maintenance for an injured worker
  • Making a false statement regarding a claim

Note: The above examples only amount to fraud if the worker or employer intentionally and knowingly provides false information

Fraud & investigation
 
Did you know?
  • Fraud involves an intention to knowingly deceive or mislead, resulting in the receipt or payment of a benefit that the person would not normally be entitled to.

    Fraud test: Would the person have received the payment or benefit if they had told the truth? If the answer is no, and they knew this, it is fraud.

  • Non-compliance is when a person does not meet their obligations under the Act regardless of whether the person deliberately avoided, or simply failed to meet their legal responsibilities. You could say its like speeding ie, youre guilty if you exceed the speed limit whether you intended to do so or not.