How To Become Eligible For Successful TPD Claim – Taylor & Scott

Injuries that prevent a person from working or earning an income can be devastating and cause considerable concern for what the future holds. 

TPD claims, or total and permanent disability claims, are a form of insurance offered by most superannuation funds, which provide a lump sum of financial support that covers medical expenses and loss of income due to physical or psychological damage suffered at work or during work related activities. 

The impairment is assessed by an approved trained assessor of permanent impairment, while a complying agreement may be signed regarding the exact lump sum settlement paid.

What is the definition of a TPD or total and permanent disability?

Most insurers offer TPD as an insurance, though they may have different definitions of what it means to be totally and permanently disabled. Typically, however, TPD is defined as:

  • An injury or illness that makes you unlikely to work again in your usual occupation 
  • An injury or illness that makes you unlikely to work in an occupation suited to your experience, training or qualifications
  • An injury or illness that makes you unlikely to work again in any capacity

Look to your superannuation provider’s product disclosure statement for clarification on what their definition of TPD is. 

Examples of injuries and illnesses that may be eligible for TPD claims include: 

  • Brain injuries
  • Back injuries resulting in spinal fusions
  • Blindness
  • Carpal tunnel
  • Chronic obstructive pulmonary disease
  • Limb amputation
  • Muscular dystrophy
  • Paraplegic
  • Physical/cognitive restrictions 
  • Pinched nerves in lower/mid back or neck
  • PTSD
  • Quadriplegia or incomplete tetraplegia-paraplegia
  • Rheumatoid arthritis
  • Significant limitations resulting from shoulder or knee injuries
  • Schizophrenia

What are the eligibility criteria needed to make a successful TPD claim?

  1. Level of disability
    You will be assessed on whether you are able to return to your prior occupation or indeed any occupation, as well as whether senses (eyesight, hearing etc.) or limbs or part of limbs have been lost.
  2. Superannuation policy
    Every superannuation is different, and some cover more than others. Many differentiate between ‘any occupation’ and ‘own occupation’ in their cover. Any occupation includes jobs that match experience and training, whereas own occupations provides cover on injuries that stem from a specific job.
  3. Minimum work history requirements
    A TPD claim must meet minimum work history requirements. Claimants are required to prove a minimum of 12 months working history, as well as whether the work was full or part time and number of hours worked.
  4. Ability to perform basic tasks
    Some TPD repayments, if required, include extra living expenses to assist with completing everyday basic activities such as walking, washing, eating or general housework. To be eligible, the claimant must prove their inability to complete such tasks.
  5. Requirements for on-going care
    Some TPD repayments, if required, include extra medical expenses to assist with on-going care as a result of the illness or injury in question. Claimants can show proof of medical appointments to demonstrate their requirements.

What are the steps in making a TPD claim?

Providing the super fund with the required information below can be time consuming. Demonstrating the right evidence to your super fund can be the difference between a successful and failed TPD claim, including making the correct payments to cover medical expenses and lack of income. 

Information required: 

  • Claim forms (correctly completed)
  • Information on education, training and work experience
  • Financial records (showing lack of wages)
  • Medical evidence (meeting TPD eligibility criteria)

Boost your chances of achieving a successful TPD claim by bringing in the experts. At Taylor & Scott, we will:

  • Examine the trust deed
  • Gather medical evidence in support of your claim
  • Negotiate with the super fund or their insurer on your behalf
  • Litigate your claim only as a last resort
  • Keep you fully informed every step of the way

No matter where you live in NSW, Taylor & Scott compensation lawyers can help, so contact us by phoning 1800 600 664 or complete the Contact Form at the top of this page. 

Take a look at some of our successful TPD claims. 

At Taylor & Scott, We Care For You. 

How can we help?