An incapacity overpayment may occur as a result of:
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delays by employers in advice to state offices of changes to normal weekly earnings (NWE) and any adjustments like higher duties, overtime and increments;
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a redetermination due to a mistake (such as incorrect information provided by employers or errors in determining entitlements);
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Comcare or employers making incorrect payments;
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changes in superannuation rates or commencement of superannuation;
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changes in circumstances not previously advised (such as an ex-employee recommencing employment);
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a redetermination of entitlements (such as retrospective cessation of liability following a reconsideration or appeal);
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the late advice of the death of an employee;
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common law or third party settlement;
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fraudulent activities;2 or
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causes listed in section 23 of the Act (imprisonment).
Irrespective of whether fraud is involved, overpayments must still be recovered. However, care should be taken to ensure that recovery is made in such a way that the fraud investigation process is not undermined or put at risk.
In all cases, the recovery process should be managed sensitively. Where large amounts are to be recovered (anything over $1,000), the issue of recovery must be discussed with either a Team Leader or the Claims Services Manager.