TPD Claims – Total and Permanent Disability Claims

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Total and Permanent Disability (TPD) insurance provides lump sum compensation to people who are no longer able to work as a result of becoming disabled. Often, it is necessary to enlist a lawyer to ensure the success of a TPD claim.

If you are suffering from an injury or illness that prevents you from working, you may be entitled to a one-time lump sum payment from your superannuation fund. TPD compensation can cover the cost of medical care, daily living expenses and more.

However, it can be difficult to know if you have a viable TPD claim. What’s more, approval of your TPD claim by the insurance company is not guaranteed.

Whether you are just lodging a TPD claim or you received notice that your TPD claim has been rejected, TPD Compensation Lawyers can help. We handle your TPD claim on a No Win No Fee basis, which means you pay us nothing unless we achieve a favourable result.


What Is TPD Insurance?

Total and Permanent Disability is a benefit paid through superannuation insurance. More than 85% of Australians are covered by TPD, with the majority holding cover through insurance provided by an employer.

Generally, a person will need to be unable to work for anywhere from 3 to 6 months as a result of disability before they can lodge a TPD claim. The condition that causes your disability does not need to be work-related for you to qualify for a TPD benefit.

Workers are often unaware that they have TPD insurance through a current or previous employer. TPD Compensation Lawyers can evaluate the available coverage and help you access the funds you need and deserve!

Who Qualifies for TPD?

One of the major difficulties attending any TPD claim is the lack of a consistent definition of what constitutes ‘Total and Permanent Disability’. Ultimately, the injury or illness that prevents you from working will need to meet the definition of TPD set forth by the super insurer.

As a general rule, someone claiming TPD will need to be completely and permanently incapacitated, resulting in one of the following:

  • The claimant is unable to return to the job he or she had prior to becoming disabled (known as ‘own occupation’ coverage).
  • The claimant is unable to perform any type of employment for which he or she is qualified (known as ‘any occupation’ coverage).

Your TPD claim must be supported by strong medical evidence that proves you are unable to work and will not be able to return to work. A wide range of physical injuries, acute and chronic illnesses and mental disorders may meet the criteria for Total and Permanent Disability.

How does a TPD claim work? | TPD Compensation Lawyers

How Do I Make a TPD Claim?

Lodging a TPD claim can be a lengthy and frustrating process. The application process generally involves the following steps:

  • First, your TPD insurance coverage will need to be confirmed. This means contacting the super insurer and confirming that TPD cover is included in the policy. You will also need to confirm that your employer has made monthly contributions to the super fund.
  • Next, you will need to complete an application to claim the TPD benefit. The superannuation insurer will review the application to determine if you have a valid TPD claim.
  • You will receive notice that your TPD claim has been accepted or rejected. If your TPD claim is accepted, a lump sum payment will be made from your super fund. If your TPD claim is rejected, you have the right to appeal the decision.

Unfortunately, up to 60% of TPD claims are rejected. Although sometimes this occurs because the application is incomplete or lacks sufficient medical evidence, many more TPD claims are rejected because of issues such as insurers adopting extremely narrow definitions of Total and Permanent Disability, difficulties in the application process and more.

TPD Compensation Lawyers can help you at any point in your TPD claim. In fact, we strongly urge you to reach out to our team as soon as possible for assistance.

Frequently Asked Questions

What Is Considered Total and Permanent Disability?

Broadly speaking, Total and Permanent Disability refers to a permanent condition (i.e., an injury, an illness, etc.) that leaves you totally unable to work. However, the precise definition varies by each super insurer. The challenge lies in establishing that you meet the specific requirements for Total and Permanent Disability used by the insurance company.

Many different health issues could give rise to a viable TPD claim—if it can be shown that you satisfy the terms of the superannuation policy. An experienced TPD lawyer can evaluate your situation and determine whether you have a claim.

What Injuries Are Covered by TPD?

Serious injuries are a common cause of Total and Permanent Disability. You may have a TPD claim if you suffer any of the following:

  • Spinal Injury
  • Brain Injury
  • Eye Injury Resulting in Vision Loss or Blindness
  • Permanent Hearing Loss
  • Disc Injuries in the Neck & Back
  • Loss of the Use of a Limb
  • Amputation Injury
  • Paralysis
  • Repetitive Stress & Motion Injuries (e.g., carpal tunnel syndrome, torn rotator cuff, etc.)
  • Severe Burns

Unlike other compensation schemes, the injury does not have to occur in a particular situation for you to lodge a TPD claim. Life-altering injuries sustained in a motor vehicle accident, at work, at home, or under any other circumstances may entitle you to a TPD benefit.

What Illnesses Are Covered by TPD?

Severe illness is a leading cause of Total and Permanent Disability. You may be entitled to TPD compensation if you have any of the following conditions:

  • Cancer
  • Heart Attack & Stroke
  • Arthritis & Other Musculoskeletal Disorders
  • Heart Disease
  • Progressive Vision Loss
  • Hearing Loss & Deafness
  • Respiratory Illnesses
  • Alzheimer’s Disease & Dementia
  • Multiple Sclerosis
  • Amyotrophic Lateral Sclerosis (ALS)
  • Epilepsy
  • Parkinson’s Disease
  • Autoimmune Disorders

Experien Insurance Services reports that mental health conditions are the most common reason for TPD claims, accounting for 24% of claims made by men and 27% of claims made by women. Mental disorders for which you may be able to claim the Total and Permanent Disability benefit include:

  • Depression
  • Schizophrenia & Schizoaffective Disorder
  • Bipolar Disorder
  • Anxiety Disorders
  • Personality Disorders
  • Impulse-Control Disorders
  • Post-Traumatic Stress Disorder (PTSD)

These are not comprehensive lists. TPD Compensation Lawyers will evaluate your medical records. We may also refer you to qualified medical practitioners who can assess your condition. All of this evidence can help our lawyers complete your TPD application. It also improves the likelihood of your claim being accepted.

Do TPD Claims Have to Be Work-Related?

No. Although work-related injuries and illnesses can give rise to conditions that may qualify for Total and Permanent Disability, your disability does not need to be work-related for you to lodge a claim.

Employers in Australia are required to carry workers’ compensation insurance. Workers’ comp provides coverage if an employee gets injured or becomes sick as a result of their job.

Total and Permanent Disability cover is a separate type of insurance policy. There is no requirement for a disabling injury or illness to be related to your employment—even if you are claiming a TPD benefit on super insurance held by your employer.

What Is the Difference Between ‘Any’ and ‘Own’ Occupation?

Eligibility for TPD hinges on the claimant’s ability to work. Super insurers use one of two definitions for determining Total and Permanent Disability based on an individual’s employment:

  1. Any occupation coverage: The most common form of TPD cover is ‘any occupation’ insurance. If you are unable to work in any capacity for which you are suited based on your education, skills, and training, you may be entitled to a Total and Permanent Disability benefit.
  2. Own occupation: ‘Own occupation’ insurance, meanwhile, provides cover if a Total and Permanent Disability prevents you from working in your current occupation. Under ‘own occupation’ coverage, you may be entitled to a TPD benefit even if you are able to find work in another field.

Generally, TPD claims under ‘any occupation’ cover are more difficult to get approved. Insurers set a high threshold for Total and Permanent Disability when an individual is claiming that they are unable to work at all. However, if this describes your situation and you are covered by super insurance, you deserve the maximum benefit.

TPD Compensation Lawyers will review the superannuation insurance policy and advise you what is required to qualify for TPD. We know the types of medical records and other evidence insurers look for when evaluating TPD claims, and we will thoroughly prepare the application on your behalf.

How Do I Prove My TPD Claim?

Multiple documents are typically required when lodging a TPD claim. In addition to your application, the following may be requested:

  • Medical records
  • Signed medical authorities (i.e., statements that authorise a medical practitioner to discuss services provided to you with the insurance company)
    • NOTE: Most super insurers require the submission of a minimum of 2 medical authorities from different practitioners
  • A resume, CV, or other document showing your employment history
  • Tax documents
  • Workers’ compensation records (if applicable)

You may be required to undergo one or more appointments with specialised medical practitioners (often known as Independent Medical Examinations, or IMEs). Undergoing an IME can further support your claim for Total and Permanent Disability; specialist doctors will evaluate your capacity for work based on a disabling condition.

Ultimately, it can be difficult to know what, exactly, the insurance company is looking for when reviewing a TPD claim. It is in your best interest to contact a TPD specialist lawyer before you try to lodge a claim on your own.

Can I Claim Income Protection and Total and Permanent Disability?

Generally, yes, you can receive both income protection payments and a TPD benefit. Income protection is a separate insurance policy from TPD insurance. Your employer may provide income protection, or you may purchase coverage on your own.

Income protection pays a percentage of your monthly income if you are unable to work due to disability. Payments continue until one of the following happens:

  • You return to work
  • The maximum benefit period elapses (varies by policy; usually 2–5 years)
  • You reach retirement age
  • Death

You can lodge a TPD claim while you are receiving income protection benefits. Once the TPD benefit is paid, you can typically still get income protection payments until one of the events above occurs. However, some super funds will require that income protection benefits cease upon the payment of a lump sum TPD entitlement. TPD Compensation Lawyers will review all insurance policies to determine what effect claiming one benefit may have on your eligibility for other forms of coverage.

How Much Is a TPD Payout?

There is no way to answer this without knowing (a) the terms of your TPD cover and (b) how much money is currently in your super fund. Our lawyers get started on your claim by reviewing the insurance policy and contacting the insurer to determine what funds are available.

A TPD payout is made in a one-time lump sum. The amount of the payment could range from $30,000 to more than $1 million, but these numbers may vary. TPD Compensation Lawyers can provide a more accurate assessment at your FREE consultation.

Is It Hard to Get a TPD Payout?

Lodging a TPD compensation claim may involve several challenges. Common issues claimants face include:

  • Multiple requests for more information: Sometimes an application may be incomplete, in which case the insurer will reach out for additional information, paperwork, etc. Depending on what’s missing, the insurance company could contact you multiple times.
  • Delays: The average time for the super insurer to complete its assessment of a TPD claim is approximately 6 months to 1 year. More complicated claims could take longer. If you have been waiting for months with no communication, the insurer could be intentionally dragging out the process.
  • Requests for Independent Medical Examinations: Most requests for an IME are considered reasonable if they can provide the super insurer with needed information on a Total and Permanent Disability. However, repeated requests for multiple IMEs could be a delaying tactic.

Many of these difficulties can be overcome by hiring an experienced TPD compensation lawyer. A knowledgeable specialist in TPD claims can help you file a complete application the first time and handle any additional communications with the insurance company. If your claim is rejected, we can promptly appeal the decision.

Why Do TPD Claims Get Rejected?

The majority of TPD claims are rejected by super insurers—at first. Some of the most common reasons for the rejection of a claim include:

  • Your application is incomplete.
  • The insurer believes that you don’t meet the criteria for Total and Permanent Disability.
  • Insufficient medical evidence is provided.
  • The waiting period has not been satisfied; TPD cover only becomes available after you have been unable to work for a defined period of time (usually 3–6 months).
  • You have not satisfied the requirements concerning work history.
  • The policy has become inactive due to lack of contributions to the super fund.
  • Your age exceeds the term set forth in the policy (eligibility for TPD usually ends at retirement age).

If your TPD claim is rejected, TPD Compensation Lawyers can help. A TPD benefit can make an enormous difference in your ability to pay for daily necessities, medical care, and more. There are multiple options for appealing the rejection of your claim, and we will fight to obtain the entitlement you deserve.

What TPD Compensation Lawyers Can Do for You

Our lawyers and staff can handle all aspects of lodging a TPD claim on your behalf. This starts with:

  • Confirming TPD insurance is included in your superannuation insurance policy
  • Finding out how much is in your super fund
  • Reviewing your employment history to confirm that you meet the minimum work requirements some insurers (but not all) have before you can qualify for TPD
  • Determining whether you have satisfied any additional conditions, such as the waiting period, degree of disability, etc.
  • Evaluating your medical records and other evidence of disability
    • Our team can connect you with any number of qualified medical practitioners who can examine you and thoroughly document the injury or illness.
  • Collecting any and all documents needed to complete your TPD benefit application

After gathering all of the necessary information, TPD Compensation Lawyers can submit your application for the TPD benefit. Our knowledgeable lawyers will ensure that your claim is complete before submitting it to the insurance company. This improves the likelihood of a timely decision on your TPD claim.

Having a TPD lawyer complete the application and lodge your claim also carries a higher likelihood of your TPD claim being approved. In the event that your TPD claim is rejected, TPD Compensation Lawyers can appeal the decision on your behalf.

Doctor accessing patient's electronic medical record on laptop computer | TPD Compensation Lawyers

How Long Do I Have to Lodge a TPD Claim?

Another important consideration in any TPD claim is what, if any, time limits apply for pursuing entitlements. Most insurers and super funds do not place a time restriction on when a TPD claim can be made, but it is important to be aware of your plan’s time limits.

For example, you may be required to lodge a TPD claim before leaving your current employment situation. Other plans may allow you to lodge a TPD claim after you moved to another job or become unable to work, but your claim must be made before a specific number of years has elapsed.

If you are unsure how long you have to lodge a TPD claim, it is always best to assume that time is of the essence and take action immediately. TPD Compensation Lawyers will carefully review the insurance policy and the terms of your super fund and get started on your TPD claim right away.

Contact TPD Compensation Lawyers Today

TPD payments can provide much-needed financial relief to people who have a Total and Permanent Disability. Unfortunately, getting the funds you deserve is not always easy.

At TPD Compensation Lawyers, our expert lawyers and staff can help you navigate the TPD claims process. We are committed to maximising your entitlement and getting you the lump sum payment you need to pay for medical expenses, cover your bills, clear any debts you may have and provide you with financial resources to maintain your standard of living.

Please tell us about your TPD claim by filling out the form at the top of this page, and a member of our team will get back to you as soon as possible. TPD Compensation Lawyers handles TPD claims for clients throughout Australia.

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