Total and Permanent Disability (TPD) provides a lump sum benefit if you can no longer work due to an injury or illness. But what if you weren’t working at the time you became disabled, or you didn’t have a full-time job? An experienced lawyer can review your insurance cover, determine the TPD work requirements, and assess your eligibility.
Insurance policies aren’t written in plain English. TPD Compensation Lawyers can cut through the jargon and offer honest insights on whether you have a viable TPD claim.
Many TPD insurance policies include ‘minimum average hours’ or other work history requirements. We can explain what these requirements are and how they apply to your unique situation.
Our TPD claims lawyers know how insurance companies operate, including the tactics they use to deny valid applications. Call 03 9966 7188 today for a FREE consultation. Based in Melbourne, we serve clients throughout Victoria.
What Are ‘Minimum Average Hours’ Requirements for TPD Claims?
Most insurance policies require you to have been working before you became disabled to qualify for a TPD payout. This is often referred to as the ‘minimum average hours’, though some insurers may use a different term.
The minimum average hours requirement for TPD claims is generally 15–20 hours per week, averaged over a period of approximately 12 months prior to your date of disablement.
You will also need to satisfy the TPD waiting period. This is the time you’ve been continuously unable to work due to a disability. Generally, 3–6 months must pass before you can lodge a claim.
Applicants often find this distinction confusing, so it’s important to clarify:
- Minimum average hours: This is the number of hours you worked per week prior to becoming disabled, with 15–20 hours being the usual threshold.
- Waiting period: This is the amount of time you have to be totally and permanently disabled, preventing you from work, before you can lodge a TPD claim (usually 3–6 months).
Some TPD policies require you to be continuously employed for 12–18 months before becoming disabled. The insurer may average the hours you worked during this active employment period to determine whether you meet the TPD work requirements.
It can be difficult to know if you meet the definition of Total and Permanent Disability. An experienced lawyer can help you navigate the intricacies of complex insurance matters and prepare a strong TPD claim on your behalf.
What Happens If You Don’t Meet the Minimum Hours?
People who were working part-time or casually before the date of disablement may not satisfy the minimum average hours requirement. In this case, the insurer may assess TPD according to the ‘Activities of Daily Living’ (ADL) standard.
The ADL definition of TPD is narrower and therefore less likely to result in a payout. Rather than basing TPD on the ability to work, ADL policies are based on whether you can perform certain daily activities. It is more difficult to satisfy this definition than insurance cover based on occupational capacity.
How to Prove You Meet the TPD Work Requirements
Your TPD insurance policy should specify the information and/or documentation you need to provide for the work history section of the application. This may include:
- Timesheets and time cards
- Payslips
- Tax returns
- Bank statements
- Communications with employers
- Employment contracts
Businesses in Australia are required to keep certain employee records for 7 years. You should be able to reach out to your employer, or previous employer, to obtain some of the documents you need to make a TPD claim. Copies of tax documents may be requested from the Australian Taxation Office, or they should be on file with the tax agent if a professional does your taxes.
The process of applying for TPD can be difficult, especially if a previous employer isn’t helpful in providing the necessary documents. You might also have trouble proving you meet the work history requirements for TPD if you were self-employed or doing freelance or gig work prior to disablement. In either case, a lawyer specialising in TPD claims can provide the expert advice you need.
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Do All Insurance Policies Have Work Requirements?
Minimum average hours requirements were once a common feature amongst TPD insurance cover. In 2020, Super Consumers Australia reported that 94% of insurers would use a more restrictive definition of TPD if claimants could not show that they worked a minimum of 15 hours prior to disablement.
Some insurers (such as AMP) have since abandoned the requirement. However, a number of TPD insurance products still use minimum average hours, especially when cover is held in a superannuation fund.
Retail and individually purchased policies are less likely to have work history requirements. If they do, the TPD work requirements may be more flexible.
A knowledgeable TPD lawyer can assess the terms of your insurance cover and the insurer’s current policies. This can save time and effort preparing your claim, as well as improve the likelihood that you will be approved for a payout.
TPD Compensation Lawyers Can Help with Your Claim
If you have a Total and Permanent Disability, a TPD payout may be an essential lifeline. Unfortunately, insurance companies often use ‘minimum average hours’ requirements to deny legitimate claims or subject them to unfavourably narrow definitions of TPD.
TPD Compensation Lawyers know what insurers look for when it comes to work history. We gather all available evidence to prove that you have met the TPD work requirements, the waiting period, and other criteria. If a dispute arises, we are prepared to fight for your entitlement on your behalf.
Contact TPD Compensation Lawyers for FREE today. We serve clients on a No Win, No Fee basis. You pay no costs upfront and only pay fees if we get your TPD benefit paid to you.