Workers compensation fraud - vilifying workers

Another type of fraud occurs where a health care provider bills for a treatment that never occurred, or over-services. The level of medical costs, as a percentage of total costs, varies between the schemes, ranging from around 13 per cent to over 20 per cent of workers compensation benefit expenditure.

In Victoria a medical peer review process began in 1995 which, according to the Victorian WorkCover Authority, has led to a change in the servicing patterns of some providers. 17 physiotherapists, seven chiropractors and four psychologists were investigated regarding the number of services per claim. In the 1996-7 financial year two providers were prosecuted, one for furnishing false information and the other for obtaining property by deception. In the 1997-8 financial year two providers were prosecuted, one for obstructing an investigation and the other for falsifying 44 invoices for treatment not provided.

Dubious activities of some providers actually resulted in legislative change in Victoria with the introduction of the Accident Compensation Act (Further Amendment) Bill in 1996.

In the last 10-15 years there has been significant legislative reform across Australia in Workers Compensation which has generally resulted in either the restriction or abolition of the entitlements of injured workers. The common reason is to lower the escalating costs of the system which have been blamed to some extent on claimants who rort the system. There is simply no evidence to support the allegation.

The blame has to be directed to where it really lies, employer premium evasion.