What Is TPD ‘Activities of Daily Living’?

12 July 2023 | Superfund Insurance

Total and Permanent Disability insurance pays a lump sum benefit if it can be shown that an injury or medical condition has left you totally and permanently disabled. The definition of Total and Permanent Disability (or TPD) varies by insurer.

In reviewing your Total and Permanent Disability insurance policy, TPD may be defined in one of the following ways:

  • ‘Own occupation’ cover (i.e., the disability prevents you from returning to your current occupation)
  • ‘Any occupation’ cover (i.e., the disability prevents you from performing any occupation for which you are adequately educated, trained, and qualified)

However, some insurers have begun implementing a different, much more restrictive threshold to qualify for TPD compensation known as ‘activities of daily living’. According to a report by the Australian Securities and Investments Commission (ASIC), claims brought under policies that employ the ‘activities of daily living’ test were denied at a rate five times higher than claims lodged under ‘own occupation’ or ‘any occupation’ policies.

TPD Compensation Lawyers will fight to get the Total and Permanent Disability insurance benefit you deserve. Call 03 9966 7188 to review your insurance cover for FREE and get started on your claim.

What Are ‘Activities of Daily Living’?

Unlike other definitions of Total and Permanent Disability, insurance policies that define TPD according to one’s ability to perform the ‘activities of daily living’ (ADL) make no reference to occupational capacity. Instead, qualifying for disability means you are unable to perform daily tasks necessary to care for yourself.

Super insurers that use the ‘activities of daily living’ test generally recognise Total and Permanent Disability if a person is unable to do two or more of the following:

Getting In and Out of Bed

Being able to get out of bed and/or into bed on your own is a key element of independence. If you are unable to perform one or both of these tasks independently, you may qualify for Total and Permanent Disability under an ADL assessment.


To qualify for TPD, the inability to walk must be total and permanent (i.e., paralysis, loss of both legs, etc.).

Bathing and Using the Bathroom

You may be eligible for TPD compensation under an ADL policy if you are unable to bathe yourself and/or see to your toileting needs without assistance.

Dressing Yourself

Issues such as loss of mobility or the use of one’s hands can make it impossible to put on or remove clothing. This may be considered Total and Permanent Disability under ADL.

Feeding Yourself

This category refers to the mechanics of feeding. If you are unable to pick up food and utensils, bring the food to your mouth, and/or swallow food safely, this may be considered a Total and Permanent Disability according to the ‘activities of daily living’ definition.

The Disadvantages of TPD ‘Activities of Daily Living’

Total and Permanent Disability insurance policies with an ‘activities of daily living’ requirement are extremely restrictive. Only the most extreme injuries and illnesses are likely to pass an ADL test. This accounts for the high rate at which TPD claims under ADL are denied.

According to consumer advocacy group CHOICE, ADL tests are usually found in TPD cover for those who engage in ‘part-time or intermittent work.’ However, CHOICE reports that ‘People who work in “high risk” or “hazardous” occupations may also have to pass an ADL test to make a claim.’

More than 4.5 million Australians could be faced with the unenviable situation of having no capacity to work but being capable (according to the insurer, at least) of caring for themselves. They are denied the money they need to make up for not working because they can take care of themselves day to day. It makes no sense, and individuals who would otherwise qualify for Total and Permanent Disability based on their occupational capacity are the ones who suffer.

The ASIC report on Total and Permanent Disability found that, in addition to low approval rates, TPD claims subject to ‘activities of daily living’ requirements are more likely to be withdrawn by claimants out of sheer frustration. Common complaints cited by ASIC include poor communication by insurers, requests for multiple medical assessments, excessive delays in processing claims, and more.

What Are ‘Extended Activities of Daily Living’?

Some insurers have introduced extended ADL cover that evaluates more generally the claimant’s ability to function, as well as their capacity for activities of daily living with assistive devices. However, the ‘activities of daily living’ under extended ADL are still narrowly defined, meaning it is often still difficult for claimants to qualify for Total and Permanent Disability.

How TPD Compensation Lawyers Can Help

During your initial consultation, our lawyers will fully evaluate the Total and Permanent Disability insurance policy. If the insurer defines disability according to your capacity for the ‘activities of daily living’, we will ensure that your TPD claim is supported by strong medical evidence. You may need to undergo one or more medical evaluations, but our team will support you throughout this process.

We will also handle all communications with the super insurer. If your claim is denied, we can appeal the decision on your behalf.

Need assistance with a TPD claim? Contact TPD Compensation Lawyers for a FREE consultation.