A TPD claim offers financial help if you’re permanently ill or injured and unable to work. In addition to physical injuries and illnesses, you may also claim TPD for mental health conditions.
What injuries may qualify as TPD?
Physical injuries
- Back injuries.
- Repetitive Strain Injury (RSI).
- Hearing loss, blindness or loss of speech.
- Finger or hand injuries that significantly impact your grip.
- Paraplegia
- Quadriplegia.
- Loss of limb or use of a limb.
Illnesses or diseases
- MS, Alzheimer’s disease, and other degenerative conditions.
- Auto-immune conditions like Rheumatoid arthritis and Lupus.
- Muscular Dystrophy.
- Primary Pulmonary Hypertension.
- Cancer.
- Asbestos disease, mesothelioma, or another chronic lung disease.
- Heart disease.
Mental health conditions
- Post-Traumatic Stress Disorder (PTSD).
- Major Depressive Disorder.
- Diagnosed anxiety disorders (as opposed to everyday stress).
- Adjustment disorder.
This is by no means a complete list. As long as you’re permanently off work, most funds and insurers will allow you to claim TPD.
However, it’s important to recognise that each TPD policy is unique, so you must ensure that your condition fits the specific definition of TPD in your policy. If you fail to do so, your TPD claim could be rejected — even if your injury permanently affects your ability to work.
Does TPD cover pre-existing conditions?
Yes, TPD may cover pre-existing health conditions. It is unlikely that your fund or insurer will automatically deny your claim just because it relates to a pre-existing condition. The only exception is if your TPD policy specifically includes a clause that prevents people with pre-existing conditions from claiming for that condition.
If you’re looking to claim TPD for a pre-existing condition, we strongly suggest speaking to a lawyer first. In our experience, super funds and insurers can be unfair to people claiming for pre-existing conditions, often rejecting claims on unjust grounds. An experienced TPD lawyer will outline your rights under your policy, and ensure you receive fair treatment from the fund or insurer.
What does TPD not cover?
While it’s important to understand what TPD covers, it’s equally important to understand what it doesn’t cover. Depending on the terms of your policy, TPD may not cover:
- Temporary injuries or illnesses: If you’re only unable to work for a few days, weeks or months, it’s unlikely you’ll qualify for TPD. Instead, you can make an income protection claim for temporary wage-replacement payments. If your injury or illness happened at (or because of) work, you could also have a workers compensation claim.
- Trauma conditions: These are conditions where you’ll likely return to work after you recover, such as a heart attack. While you’re off work, you may be eligible for income protection payments. If your condition was caused or exacerbated by work, you may also have a workers compensation claim.
- Self-harm: Most TPD policies will not cover you for permanently disability caused by deliberate self-harm.
- High-risk occupations: If your job is considered high risk, the super fund or insurer may exclude some conditions caused by your job. As a general rule, the more high-risk your job, the more exclusions that apply. These exclusions must be explicitly listed in your policy.
- Pre-existing conditions: As discussed, TPD may not cover pre-existing conditions if your policy specifically excludes claiming for that condition.
- Conditions outside the definition of TPD: No matter how debilitating or severe your condition, it’s unlikely you’ll be eligible for a TPD benefit if you don’t meet your policy’s specific definition of TPD.
This is just a rough guide — as with every aspect of TPD, your policy determines exactly what you’re covered for.
How we can help
To make a successful TPD claim, it’s essential to understand what injuries and illnesses your policy covers. This goes beyond simply reading the policy; you must interpret its terms and fulfil all requirements from your super fund or insurer. While this may sound complex, our specialist team are here to make it simple.
With 25 years’ experience in TPD claims, we have the skills to fully investigate your policy and find out exactly what you’re covered for. Your lawyer will also gather compelling evidence for your claim, manage all negotiations, and contest any evidence presented by your fund or insurer.
Best of all, our No Win No Fee guarantee means your claim is absolutely risk-free.
We cover all initial expenses, including doctor’s visits and expert reports, and you won’t pay anything until we win your case. If we don’t succeed, you will never receive a bill from us.
Contact us today for free advice on your TPD claim. Find out what your policy covers and how to secure your full benefit fast.
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