How many people are really rorting the workcover system?

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Workcover authorities in NSW, Victoria and Western Australia have confirmed the number of prosecuted (injured workers) frauds is very small – so negligible, in fact, it’s an almost incalculable fraction of the overall number of claims. Notwithstanding the evidence the media still tend to give a seriously skewed presentation on the fraud problems with the system.

Although the following journalist admits that injured workers’ fraud is in fact negligible, he still highlights 3 cases of fraud and in detail. In addition he also highlights the consequence of [the perception of widespread fraud] ends up being employee stigmatisation.

Injured workers’ stigmatisation s basically an institutionally-embedded expectation that all injured workers will violate or abuse entitlements. This has been embedded into our society through the media (i.e. exposed “fraud” by injured workers; special anti-fraud branch of WorkSafe; overuse of IMEs, Video surveillance etc.) and is basically achieved through practices and bureaucracy (i.e. Doctor, IME validation of injury/illness, forms for employers etc). And, yes, this adds a social injury to a physical injury

So why the need to provide lengthily details in his article about those 3 fraud cases? It only reinforces the belief that injured workers are all fraudsters. Again, we believe this is a media stinger, under disguise.

How many people are really rorting the workcover system?

Work in ProgressThe dodgy side of workers’ comp

by Work in Progress | 2 July 2015
James Adonis is one of Australia’s best-known people-management thinkers

As a kid, I remember hearing an uncle of mine, now deceased, boasting about the workers’ compensation payments he’d been receiving for years. It was some sort of neck injury, one that didn’t actually exist but enabled him to proudly rort the system. I was appalled anyone could view this as a badge of honour, which is what he (and his family) smugly did.

Fast forward to last month and the revelation Australian public sector workers were faking serious medical conditions in order to apply for workers’ comp payments. Complaints of fraud have apparently increased by 15 per cent in the past year, with many employees allegedly using the time off work to earn extra income via a second job.

And that’s in the public service where the funds, resources and manpower exist to handle these abuses. It’s a much harder exercise in small businesses that are often constrained by time and money. Indeed, depending on the state you’re in and the size of your business, your premiums increase in concert with your claims history.

Here are a few recent examples of people who were caught cheating the system. All three (and more) are freely available on the prosecutions page of Victoria’s WorkSafe website. What this means is that if you’re so inclined to take the system for a ride and you’re subsequently busted, your name will forever be plastered on the inerasable forum that is the world wide web.
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One bloke claimed to have injured his back and was awarded generous weekly payments … until he was observed being the driver in a high-speed motor race. Really, you’d think you’d lay low, right? He had to pay back more than $97,000 and in November was given a suspended prison sentence of six months.

Another guy, while pulling a trolley at his workplace, strained his muscles, ligaments, neck and back, and was therefore declared unfit for work. But despite being in regular receipt of workers’ comp payments, he was captured by covert surveillance working as a tyre fitter during which he was effortlessly bending and pulling, lifting and carrying, and handling heavy stuff. He was ordered to pay nearly $19,000 in restitution and to perform 400 hours of community service.

The third case is the most remarkable. A female employee had a workplace accident that resulted in the amputation of her leg, thereby rendering her wheelchair-bound. Her workers’ comp payments were then justifiably inflated to account for the 24-hour care she needed. Except she wasn’t actually wheelchair-bound. And she didn’t have any carers looking after her. She was sentenced to 12 months in jail and had to pay back $112,000.

Despite the above, an analysis published in the American Journal of Industrial Medicine in 2012 suggests the prevalence of workers’ comp fraud is actually a myth perpetrated by employers and insurance companies. The collective ambition of these bedfellows is seemingly to curtail the benefits provided to those who are injured at work even though the proportion of cases found to be fraudulent is quite tiny.

Similarly, workers’ comp authorities in NSW, Victoria and Western Australia have confirmed for me this week the number of prosecuted frauds here is just as small – so negligible, in fact, it’s an almost incalculable fraction of the overall number of claims. For example, in the most populous state, NSW, there have been just five prosecutions in the past two years.

So while the anti-workers’ compensation rhetoric continues to be louder than the reality, the consequence ends up being employee stigmatisation. It’s a stigma that compels those who are legitimately entitled to make a claim to refrain from doing so because they’re fearful of the impact it’ll have on their reputation and their career.

Which is another example of a few bad eggs spoiling it for everyone else.

[Source: http://www.watoday.com.au/small-business/managing/work-in-progress/the-dodgy-side-of-workers-comp-20150702-gi34oq]

 



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6 Responses to “How many people are really rorting the workcover system?”

  1. This kind of reporting really gets me angry. I have told anyone who will listen that if you had any desire to ‘rort’ the system, why the hell would you ever choose workers comp? It would be easier to rob a bank. If you are on the disability pension, you do not have case managers harassing you, you do not have anyone threatening to cut you off, forcing you to go to unethical doctors or lying about your medical state. In fact I know of several people who are on this, who have been treated for their condition and recovered but are still on it. That is not to say that all people on the disability pension do not deserve it and yes they are subjected to the rorting accusations as well.

    The point is that for some reason in this society we are encouraged to think that people are rorting. Is that because most people hate their jobs and perceive an injury is a way to get out of that job? There is never any genuine concern about the true rorters, like banks, financial managers, tax avoiders and yet with workers comp, it is a free for all attack and few journos ever report the statistic that only 0.05% of injured workers are fraudulent.

    It is bad enough that injured workers have to suffer a denial of basic human rights without the disgusting implications that somehow they are faking it. Does anyone realise how hard it is to fake an injury or how impossible it is to fake X Rays and MRIs? It is also an assault on the expertise of your doctors who have the training to diagnose you and the medical evidence to support it. Don’t you just love those people who give you medical advise about your injury when they are not doctors? That is another form of implying that you are rorting. Yes we all know the stories of the cousin thrice removed who was on workers comp for 30 years and there was nothing wrong with them. Problem is that “we” never ever saw their medical reports, so how the hell would we know if that was correct?

    This is all a case of ‘walk in my shoes’ because most people have no idea what it is like to be an injured worker until it happens to them. I challenge any journalist who has been injured at work to write the truth about what it is really like.

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    • Dear Bunny,what I think when it all comes down to it people think we get millions of $$$$$$$$ from being hurt on the job.They have no idea what it is like till they walk the path and sometimes I think it would do some people the world of good to get a taste of what we go through.The public is so misinformed its not funny but nobody such as ACA and all the rest have the guts to expose it for what it really is,because everybody except the injured worker makes money.And when it is all said and done people are jealous they think we are getting money for nothing BULLSHIT,the only lucky worker is the one who doesn’t get hurt.

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      • @Tony- Yep thought the same thing the other day. What is truly astounding is
        the Lawyers know about the corruption, ACCS reps know, Conciliators know, VWA workers know-
        Seems to be ALL the people that COULD do something about the corruption, law breaking and bullying are fed too well from the trough
        No wonder this system survives. As an ex employer -I would be JAILED if I treated my staff like this!
        Skippy out

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        one legged skippy July 10, 2015 at 4:10 pm
    • Anybody who rips off the system deserves to have bucket loads of shit dumped on them from a great height.
      However, the media doesn’t give much attention to the fraudulent activities of many IMEs and Insurers who deliberately falsify diagnoses to keep in the Insurer’s good books. Or the systemic doctor shopping by Insurers until they find a diagnosis that suits them.
      Let’s expose all fraudulent activities in Workers Compensation Schemes and all genuine injured workers would rejoice.

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    • @ Peter, Whilst we do agree that the few people doing the wrong thing should be caught, what is not reported in this article is that, for example, figures obtained by Freedom of Information showed that in 2010-11, WorkSafe VIC (VWA) spent $13.7 million watching 6675 people claiming benefits. The cost was more than $1.2 million above the previous year’s bill for watching 6217 people, but it prosecuted just 18 cases of fraud. From the stats provided by the Herald Sun’s current article, in 2010-11 only 8 (of the 18) cases were successfully prosecuted by the VWA (however that is not to say the VWA may have ‘settled’ the other prosecuted cases out of court). So, in effect in 2010-11 the VWA spent just about 14 million dollars to recover (prosecute) 8 cases worth $430,000.

      Basically, one could interpret that millions (14 million) are being spent putting mostly good, honest people under surveillance, large amounts of money being spent, for what appears to be a very limited return (on investment – time and money).

      Would the VWA not be better off redirecting these funds to preventing workplace injuries and helping injured workers obtain prompt medical (and like) treatment and help them get back to work?

      See: http://aworkcovervictimsdiary.com/2014/09/workcover-cheats-ripping-millions-really/

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