Worker jailed for ‘breathtakingly audacious’ WorkCover Vic fraud

workers-comp-fraud

Workcover fraud is frowned on by all. Deepening the stereotype to those who sustain legitimate injury. Time and time again, it is important to remind readers that only 1%  9or less) of injured workers defraud the system. Media sensationalisation has tarred injured workers with an unjust false brush….

Stereotypes of workcover fraudulence through workplaces turn injured workers into criminals. Insurance companies and medical professionals are not naive of the patho-physiology of workplace injury. They know how an injury is likely to progress with and without medical assistance. This makes “faking” injuries difficult. Pathology results will support injury and its processes.

When co-workers are educated, the situation falls into perspective and the ignorance generated by the stereotypes diminishes. In this “fraud” case it’s not disclosed in these articles the full particulars of this injured workers case history or why/how this verdict was reached.

The extremity of the sentence,(16 months) suggests this will not be an uncommon practice in the future. The 95% of honest injured workers would like this practice of jail sentencing workcover fraud to be extended far beyond the parameters of injured workers. Jail sentences for ALL who fraudulently and deceptively take advantage of Workcover for their own financial gain, mismanagement practices, abusing workcover funding, including those who abuse and show willful negligence to the injured worker. Time will eventually tell where the balance of fairness will rest.

Worker jailed for ‘breathtakingly audacious’ WorkCover Vic fraud

An injured worker who fraudulently obtained $112,000 in benefits, after falsely claiming to be wheelchair-bound and in need of 24-hour care, has been jailed for 16 months in Victoria, but will appeal the sentence.
Ms M, 44, of Epping, appeared at the Heidelberg Magistrates’ Court last week after pleading guilty in August 2012 to one count of fraudulently obtaining weekly compensation payments and seven of providing false information.
Information falsified by carers, too

The court heard that M’s leg was amputated below the knee in 1990 as the result of a 1985 workplace injury.

Between July 2008 and June 2010, M visited medical practitioners and claimed she was wheelchair-bound, unable to work and in need of 24-hour care.

During this period, she received $59,687 in compensation payments, but video surveillance obtained in a WorkSafe Victoria investigation showed M could move freely on her prosthetic leg and was capable of living independently.

The court heard the investigation also found six carers submitted $52,500 in attendant care invoices during that same period for services they never provided to M and split the proceeds with her. Two of the carers were M’s nieces.

In 2011, the six carers were charged with various offences under the Crimes Act and the Accident Compensation Act, including falsifying records and providing false information.

Exploitation

In sentencing, Magistrate Suzanne Cameron said Mercuri’s offending was “breathtakingly audacious” and that she exploited the WorkCover scheme for her own benefit.

‘You were clearly the mastermind and the primary beneficiary,’ she said.

Magistrate Cameron jailed M for 16 months, with eight months of her sentence suspended for two years. She was also ordered to repay $112,000.

M’s lawyer has lodged an appeal against the sentence. She was bailed to appear at the County Court in March.

Legitimate cases undermined

WorkSafe’s injury support and service executive director, Len Boehm, said cases like this undermined legitimate cases that needed financial support and care.

‘Our scheme exists to provide short medium and long term care where it is warranted and ultimately to help people return to work and social interaction,’ he said.

‘While [M] had suffered a serious injury and was entitled to help, she consistently overstated the extent of her incapacity for a number of years.’

‘The community can’t tolerate fraud of this deliberate scale. It undermines those who are hurt, particularly those with a capacity to work.’

‘It plants a perception that a large number of people on compensation have fraudulent claims. That is absolutely not the case and I know it is immensely frustrating for those who do the right thing when they hear about cases like this.’

‘We want this case to serve as a reminder that fraudulent activity will not be tolerated. When it’s detected, it will be investigated and offenders prosecuted.’

http://www.workplaceohs.com.au/injury-management/insurance/worker-jailed-for-breathtakingly-audacious-workcover-vic-fraud

http://www.heraldsun.com.au/news/law-order/amputee-jailed-for-164000-welfare-fraud/story-fnat79vb-1226561672672

13 Responses to “Worker jailed for ‘breathtakingly audacious’ WorkCover Vic fraud”

  1. this is a very sad outcome for rita. i hope rita will be successful in her appeal next month. they were filming her on: 13/12/2009 ( 14:22 ), 29/3/2010 ( 10:51 ), 26/5/2010 ( 12:52 ), 13/12/2009 ( 10:54 ), 26/5/2010 ( 12:54 ).

    there has been photo’s of her prior to video. it appears the investigation took too long “intentionally”. i wonder what instructions rita gave her lawyer in the past regarding “all issues and entitlements” dating back since her injury 1985 and also now regarding the appeal. it appears to me the lawyer or lawyers (law firms) in the “past” or present may not of entirely acted toward rita’s benefit. strange.

    HuntingWorkcover February 1, 2013 at 2:56 am
    • I only watched one of those video news (there is an article on this blog about her) and I felt too disgusted to see TV troupes (around 7-6 paparazzi) obstinately harassing and stalking this amputee, isn’t this illegal?

      Now it’s even more harder for her to fight back, she has to return $112,000 add legal fees and a Lawyer who might have been bribed by the adversarial side, she won’t make it. Why they can’t tell the full story, that is the answer!

      Xchangingvictim February 1, 2013 at 8:47 am
  2. $112,000.00 wow so thats news well work cover get you heads out of your bureaucratic arses we are being bent over and bonked and you want too let the world know that you caught a women committing fraud what about the full story

  3. This woman suffered five years of post injury stress and workcover before her injury had deteriorated to the point that it was amputated! We don’t know her full story at all. We do know she was expected to live with a severe injury on less than $600 a week. To me it looks like another injured worker driven mad by the system. And yes, Xchangingvictim it is strange that the insurer took so long to pick this up.

    As for when the heads of CGU are jailed for ripping off twenty times what this woman took, all I can say is: Don’t hold your breath waiting!

  4. Research has indicated that the greatest amount of fraud committed by those in the Workcover systems are actually rehabilitation providers. Why is there NEVER any articles in the media about this?

    • I believe it expands far further than just Rehab providers. An insurance rehab provider that were referred to, called me a Mallingerer in writing and sent this to my employer, GP and Specialist but not to me! That person later retracted this from the report without a formal apology to not only myself but the recipients of the report or ‘rehab plan’!

  5. I agree whith that statement Xchangingvictim. I am often seeing and now experiencing how insurer’s get away with what they’re doing to us all. The article is sad and makes the majority of legitimate claims & victims look bad. But we don’t know the full story and perhaps there was legitimate reasoning behind why she did this. She is an amputee and it may have been a way to fund other requirements for her injury that the system does not accommodate for. Let’s face the facts. is it really ‘compensation’? Desperation is a stinky cologne!

  6. It seems too strange to me that Workcover took so long to uncover this amputee’s illegal activity, I’m sure they knew that on the spot but they wanted to share even more business with their investigative partners and waited more to make a bigger case against the honest injured workers.

    Perhaps, I never heard that that Workcover authorised agent’s CEO “the insurer” being jailed for intentionally stealing “millions” of dollars to the welfare system for his own gain, yet they repaid back some of the money BUT no one was sentenced in addition they are still running the business as usual.

    If what that amputee did was a criminal offense punishable with a jail sentence, then all Workcover insurance’s CEO had to go jail long time ago. Maybe I can assume that stealing $112,000 to the system is punishable with a jail sentence whereas stealing “millions” entitles you a “pat” on the shoulder and “don’t do it anymore”???

    • My employer’s refusal to provide RTW assistance has been shown to have literally cost the “system” well into six figures.

      Despite this, the same prosecutor who targeted this poor woman spent nearly a year deciding that pursuing my employer through to courts did not meet WorkSafe’s “prosecution guidelines”. In other words, they only go after soft targets, not large corporations.

      • That is clearly something to do with the Lawyer!

        Xchangingvictim February 1, 2013 at 2:03 pm
        • They just wont bite the hand that feeds them. After all, it’s employers who pay the wages of every single WorkSafe employee – lawyers included.

          Workers are just busy stealing “their” money, right?

          • I must disagree: the employer only pays an initial $500 (guess it’s insurance’s fees) then the insurer keeps on going also you should know that the insurer then gets paid from the workcover, the workcover then gets money from….. well I think you know where from, it’s “always” from us who pay taxes, we are the dogs who bite our tail.

            Xchangingvictim February 1, 2013 at 3:18 pm