TPD Claims for Mental Illness

Handling Mental Illness TPD Claims for Clients in Melbourne and All of VIC

It can be challenging to lodge a successful TPD claim for mental illness. However, if your mental health impacts your ability to work or live on your own, you owe it to yourself to explore your entitlement to Total and Permanent Disability compensation.

Mental illness is often misunderstood, and severe mental health problems may be dismissed by employers and super insurers alike. No one should be stigmatised for their mental health, and seeking qualified legal support is often key for obtaining a disability benefit.

TPD Compensation Lawyers have the skills and experience to help you make a TPD claim for mental illness. We represent clients throughout Victoria from our office in Melbourne. Call 03 9966 7188 today for a FREE consultation.

Can I claim TPD for mental health? | TPD Compensation Lawyers

Does TPD Cover Mental Illnesses?

Yes, superannuation insurance policies generally do provide TPD cover for mental illnesses the way they would a physical injury or illness. However, some policies may exclude pre-existing conditions. If you previously received treatment for a mental illness—even if it was for a brief period many years ago—the insurer may consider that a pre-existing condition and add a blanket mental health exclusion.

A lawyer specialising in TPD claims can review the fine print on your insurance policy to determine if any mental health exclusions apply. Such policies may also be challenged in court on the grounds of unlawful discrimination.

When Is a Mental Illness Considered a Total and Permanent Disability?

The legal definition of disability is totally separate from Total and Permanent Disability, which is a term used by insurers. Each insurance company uses a specific definition of Total and Permanent Disability. Only by meeting this definition will you be able to obtain a TPD benefit.

You may have a TPD claim for mental illness if you meet one of the following criteria:

  • A mental illness prevents you from doing your job (‘Own Occupation’ cover).
  • You are unable to work any job for which you have the necessary education, experience, training, etc. as a result of a mental illness (‘Any Occupation’ cover).
  • A mental illness prevents you from performing the ‘activities of daily living’ (‘Activities of Daily Living’ cover).

Mental illnesses account for a significant portion of the TPD claims received by super insurers in Victoria and throughout Australia. They will closely scrutinise applications centred on mental health issues, potentially making it difficult to obtain an entitlement. Consulting a knowledgeable lawyer is essential for ensuring that your application is complete and likely to meet the threshold set by the insurance company.

Male therapist comforting a female patient | TPD Compensation Lawyers

What Are the 10 Most Disabling Mental Illnesses?

Mental illness comes in many different forms. Some individuals are able to manage with the aid of psychotherapy and medication, while others endure significant distress and disruption of their daily lives.

TPD Compensation Lawyers can determine if you are eligible for a Total and Permanent Disability benefit and help you navigate the process of making a claim. Mental illnesses that are most likely to result in a Total and Permanent Disability include:

1. Major Depressive Disorder

According to Psychology Today, mood disorders as a whole are associated with the highest rate of functional impairment (including days missed from work, difficulty performing work-related tasks, etc.). Of these conditions, major depressive disorder is the most prominent when it comes to discussions of disability.

Major depressive disorder is characterised by the following symptoms:

  • Persistent sad, anxious, or ‘empty’ mood
  • Loss of interest or a lack of pleasure in favourite activities
  • Feelings of hopelessness or pessimism
  • Irritability
  • Fatigue or loss of energy
  • Difficulty concentrating
  • Memory troubles
  • Struggles with decision making
  • Insomnia or sleeping too much
  • Changes in appetite or body weight
  • Thoughts of death or suicide
  • Headaches
  • Cramps and problems with digestion
  • Aches and pains with no clear cause

If you feel overwhelming sadness every day—to the point where you are unable to focus on work or even get out of bed—you may be entitled to a TPD benefit.

Read More: Can You Get TPD for Depression?

2. Schizophrenia

Schizophrenia is a serious mental illness that affects a person’s thought processes, behaviour, and emotions. The symptoms of schizophrenia can vary in intensity and duration, and may include:

  • Hallucinations: Perceptions without actual external stimuli, such as hearing voices or seeing things that are not there.
  • Delusions: Strongly held false beliefs that are resistant to reasoning or contrary evidence.
  • Thought Disorders: Unusual or dysfunctional thought patterns, which may manifest as disorganised thinking, difficulty organising thoughts, or trouble connecting thoughts logically.
  • Affective Flattening: Reduced expression of emotions through facial expression, voice tone, or gestures.
  • Anhedonia: Reduced ability to experience pleasure from activities previously found enjoyable.
  • Avolition: Lack of motivation to initiate and sustain purposeful activities.
  • Social Withdrawal: Decreased interest in social interactions and relationships.
  • Impaired Executive Function: Difficulty focusing, organising thoughts, and making decisions.
  • Memory Impairment: Challenges in remembering information and processing new information.

3. Bipolar Disorder

Bipolar disorder, also called manic depression, is a mood disorder that can lead to Total and Permanent Disability. It is characterised by extreme changes in mood that shift from manic to depressive episodes.

Symptoms may include:

  • Manic Episodes:
    • Elevated or irritable mood
    • Increased energy and activity
    • Racing thoughts and fast speech
    • Decreased need for sleep
    • Impulsive behaviour and poor judgement
    • Grandiose beliefs about one’s abilities
  • Depressive Episodes:
    • Persistent sadness or low mood
    • Loss of interest or pleasure in activities
    • Changes in sleep patterns (insomnia or hypersomnia)
    • Changes in appetite or weight
    • Fatigue or loss of energy
    • Feelings of worthlessness or excessive guilt
    • Difficulty concentrating or making decisions
    • Thoughts of death or suicide

4. Substance Use Disorder

Addiction to alcohol and drugs (known as substance use disorder) can take a toll on one’s physical and mental health. This includes the ability to work.

Individuals who suffer from alcoholism or drug addiction may be able to lodge a TPD claim for mental illness. Obtaining proper medical care is essential, as the insurer needs to be satisfied that the condition will not improve with further treatment (and therefore constitutes a Total and Permanent Disability).

5. Obsessive-Compulsive Disorder

People with obsessive-compulsive disorder (OCD) experience persistent, unwanted thoughts (obsessions) and engage in repetitive behaviours or thought processes (compulsions) to find relief. The cycle of obsessions and compulsions can interfere with multiple aspects of daily life, leading to significant distress.

Compulsive rituals are time-consuming, and obsessions can make it difficult to concentrate on work-related tasks. This can lead to issues such as reduced productivity, increased stress and anxiety, interpersonal challenges, and absenteeism. You may have a TPD entitlement if OCD symptoms are severe enough to prevent you from working.

6. Post-Traumatic Stress Disorder

Exposure to a traumatic event may result in post-traumatic stress disorder (PTSD). Symptoms of PTSD can vary, but they generally fall into four main categories:

  • Re-experiencing the traumatic event by way of flashbacks, nightmares, and intrusive thoughts
  • Emotional numbing and avoidance of reminders
  • Negative changes in mood and cognition
  • Irritability, difficulty concentrating, hypervigilance, and sleep disturbances (known collectively as hyperarousal)

7. Panic Disorder

A panic attack is a period of intense fear or discomfort. Individuals with panic disorder suffer recurrent and unexpected panic attacks. These attacks can occur suddenly, without any apparent trigger, and often lead to significant distress.

According to Beyond Blue, approximately 5% of Australians experience a panic disorder at some point in their lives. People with panic disorder may find it difficult to hold down a job.

8. Adjustment Disorder

Adjustment disorder is characterised by emotional and behavioural symptoms that occur in response to a specific stressor or life event. Symptoms may include:

  • Feelings of sadness or hopelessness
  • Anxiety
  • Changes in social or occupational functioning

The condition generally develops within 3 months of the triggering event and typically resolves within 6 months. In rare cases, however, adjustment disorder may persist. If the condition doesn’t respond to treatment and impacts your ability to work, you may be entitled to TPD compensation.

9. Borderline Personality Disorder

Individuals with borderline personality disorder experience pervasive patterns of instability in interpersonal relationships, self-image, and emotions. Difficulty maintaining employment is common due to issues such as intense mood swings, difficulties with self-identity, and challenges in maintaining stable relationships.

10. Eating Disorders

Eating disorders are mental health conditions characterised by disturbances in eating habits, body image, and weight management. They often involve extreme and unhealthy behaviours related to food consumption.

Common eating disorders include:

  • Anorexia nervosa: An eating disorder characterised by an intense fear of gaining weight and a distorted body image, leading to self-imposed starvation and excessive weight loss. Individuals with anorexia often exhibit extreme dietary restrictions, engage in obsessive weight control behaviours, and may exhibit a relentless pursuit of thinness.
  • Bulimia nervosa: An eating disorder characterised by episodes of binge eating, during which individuals consume large amounts of food in a short period, followed by self-induced vomiting, excessive exercise, fasting, and other behaviours to avoid gaining weight. Bouts of bingeing and purging can lead to serious physical and mental health complications.
  • Binge eating disorder: An eating disorder characterised by recurrent episodes of consuming large amounts of food in a short period, accompanied by a lack of control during the episodes. Binge eating disorder is associated with feelings of guilt, shame, and distress, and it often leads to overweight or obesity.

The physical and psychological impacts of eating disorders are serious. You may have a TPD claim for mental illness if the physical and/or psychological effects of an eating disorder prevent you from working.

If you are in crisis, call Lifeline Australia straight away at 13 11 14.
Distraught young man sitting in the corner of a room | TPD Compensation Lawyers

How Do I Lodge a TPD Claim for Mental Illness?

Making a successful TPD claim for mental illness can be difficult. Psychiatric disorders are often considered ‘invisible illnesses’ because they typically lack discernable symptoms. This can lead to incomplete medical documentation of the mental illness, reluctance to seek treatment, and other issues that can complicate the process of claiming TPD.

Nonetheless, the effects of mental illness are very real. People with these conditions may be entitled to Total and Permanent Disability compensation if they can’t work or struggle to care for themselves. You owe it to yourself to explore your TPD insurance cover and determine your eligibility.

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You will need complete medical records to lodge a TPD mental illness claim, including:

  • Records from psychiatric assessments and evaluations that led to the diagnosis of the mental health condition
  • Documentation of the treatments received, including individual or group therapy
  • Records related to any hospitalisations for mental health reasons (if applicable), including inpatient or outpatient treatment
  • Information on prescribed medications, dosage, and duration of use
  • Progress notes and reports from mental health professionals, psychologists, and/or therapists providing counselling or psychotherapy
  • Documentation that outlines the functional limitations and impairments resulting from the mental health condition, as assessed by a mental health professional
  • A comprehensive medical history, including any co-occurring medical conditions that may contribute to or affect the mental illness
  • Reports and assessments from a psychiatrist, neuropsychologist, and other specialists

You will also need to submit information about your work history, including records of any accommodations or modifications made in the workplace due to your mental health condition. If you are unable to work in spite of accommodations made by your employer, you may have a claim for TPD.

TPD Compensation Lawyers Can Help

Living with mental illness has a number of challenges. If your condition has prevented you from doing your job (or any kind of work) for 3–6 months, you may be entitled to a Total and Permanent Disability benefit.

TPD Compensation Lawyers handle claims involving mental illness with the utmost discretion and sensitivity. Our team works to understand your unique situation, assess the available TPD insurance cover, and maximise your entitlement. With our No Win, No Fee policy, you pay nothing for our services upfront and will only pay fees if we successfully resolve the matter.

It can be difficult to make a TPD claim for mental illness on your own. The key to a successful outcome is to consult a lawyer specialising in TPD claims as soon as possible.

For a FREE consultation, call TPD Compensation Lawyers at 03 9966 7188. Our firm serves clients in Melbourne and throughout Victoria.