TPD Claims Lawyers

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If an injury or illness has left you unable to work, you may be entitled to make a TPD (total and permanent disability) claim via insurance attached to your Superannuation fund.

When life throws a curveball in the form of an injury or illness, leaving you unable to work, it's a daunting prospect. 1 in 3 Australians will be unable to work due to injury or illness before reaching retirement age. However, there may be a silver lining if you're covered under an insurance policy attached to your Superannuation fund called Total and Permanent Disability (TPD) insurance.

If you find yourself no longer able to carry out your regular duties or any suitable work due to a long-term injury or sickness, then filing a TPD claim could provide you with lump sum financial support needed to help you navigate your new circumstances.

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An Introduction to TPD Claims: What You Need to Know

What is TPD Insurance?

Total and Permanent Disability (TPD) insurance provides cover if you are unable to work again due to an injury or illness. In such circumstances, filing a TPD claim through your Superannuation insurance policy could provide you with a lump sum payment. This crucial financial support can help cover the costs of medical treatment, daily living expenses, and facilitate lifestyle adjustments needed due to the disability.

Do I have TPD Insurance?

If you have an active Superannuation policy then you probably have TPD insurance. TPD insurance is typically bundled with your Superannuation account so you may not be aware you had this policy. In fact, over 60% of Australians are not aware that they have TPD insurance through their superannuation. These claims, lodged through your superannuation insurance policy, can result in significant financial support; however, the exact value varies from one policy to the next and will be stated on your policy documents.

How can a lawyer help?

Engaging a TPD lawyer early on often enhances your claim's success rate. Legal professionals in this field understand the nuances of the complex TPD law and can advise you on how best to present your case, therefore maximising your potential of the claim being approved.

How Much Are TPD Claims Worth?

The value of TPD claims can vary and are influenced by factors such as your Superannuation provider and your age. The amount of cover will typically be shown in your Superannuation account statements, policy documents and via their online portal. Cover levels can range from low tens of thousands of dollars to several hundred thousand dollars. Factors that influence this include:

Your Superannuation fund

Different funds have different default levels of cover. This is the cover level you receive unless you opt to pay for additional coverage.

Your Occupation

Some policies have policies that provide additional cover to lower risk workers such as 'white collar' worker cover. These may be applied automatically or you may have needed to opt in if available. Some funds also offer 'own occupation' cover which means you may be able to claim if unable to work in your own profession but still capable of some work elsewhere.

Your Age

Many funds vary the level of cover by age, typically reducing the payout amount as you approach 70.

Are You Eligible for a TPD Claim?

In evaluating your eligibility for a TPD claim, insurance providers will look to establish whether you're likely unable to ever work again due to injury or illness. Consequently, you have to meet certain criteria:

Absent from Work

Being absent from work due to an illness or injury for a consecutive period, typically six months

Having Evidence

Having evidence that supports your claim that your injury or illness prevents you from ever returning to work

Medical Certification

Possession of a medical certification affirming your inability to work due to the ailment

Assessing Your Situation

Typically, TPD claims revolve around the standard of 'any occupation' policy - which indicates you are incapable of engaging in any form of employment for which you are reasonably fitted by education, training, or experience.

However, 'own occupation' cover serves as an exception to this standard. 'Own occupation' cover translates to the inability to conduct the specific occupation you were undertaking at the time of your injury or illness, even if you potentially could seek employment in another field. This type of cover can be beneficial, but it's not as common as the 'any occupation' clause, and often carries higher premiums. It's essential to understand your superannuation insurance policy thoroughly, including any limits or exceptions.

Common Injuries That May Qualify for a TPD Claim

Individuals might find themselves no longer able to work due to a diverse myriad of injuries or illnesses. For a TPD claim to be valid, the impairment must be both total and permanent, making one's return to work in their prior capacity improbable. Common instances of conditions that may satisfy the TPD definition include:

Spinal Cord Injuries

Catastrophic injuries involving the back or neck can often lead to debilitating circumstances, making it impossible for the person to return to pre-injury duties.

Mental Disorders

Conditions such as severe depression, anxiety, post-traumatic stress disorder (PTSD) can impact one's capacity to carry out their occupation to such an extent that they might qualify for a TPD claim.

Cancer

The severe physical and mental toll caused by cancer and its treatment can make working an impossible task for some, leading to potential eligibility for TPD benefits.

Chronic diseases

Conditions such as severe diabetes, arthritis, asthma, and heart ailments can profoundly impact a person's ability to work, potentially making them eligible for a TPD claim.

Keep in mind, however, this list is not exhaustive. Each claim's merit hinges upon the overall impact the condition has on the person's ability to work. Understanding your specific condition and how it fits within the TPD claim requirements is vital.

Understanding the TPD Claims Process: Step-by-Step

The TPD claims process, when guided by a lawyer, often follows this sequence:

Initial Consultation

You and your lawyer have an in-depth discussion about your circumstances, injury, or illness. The goal here is to understand your situation and eligibility for a TPD claim.

Gathering Evidence

A collection of crucial documents such as medical records, employment history, and witness statements ensues. These serve as proof of your inability to work due to an injury or an illness, fortifying your claim.

Claim Form Completion

Your lawyer will assist you in comprehensively filling the TPD claim form, ensuring you include all pertinent information and eliminate any errors.

Submission of the Claim

After a meticulous review, your TPD claim, along with the supporting evidence, is submitted to your Superannuation fund.

Track Claim Progress

Your lawyer will stay in continuous contact with the fund to monitor the progress of your claim.

Claim Decision

Your Superannuation fund makes a decision - approve or deny your claim. The decision is usually based on the evidence provided and the terms and conditions of your specific policy.

Dispute the Decision

If your claim is denied, the lawyer can aid you in lodging an appeal against the decision, ensuring to put forth stronger evidence and make a more robust argument on your behalf.

This step-by-step procedure is an approximate guide and can vary depending upon individual circumstances and the specific protocols of your Superannuation fund.

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Gathering Evidence: Building a Strong TPD Claim

One of the crucial elements in a successful TPD claim is substantial evidence to support your case. Accumulation of comprehensive and compelling evidence can significantly increase the possibility of achieving the desired outcome. Here are some key considerations to keep in mind:

Medical Evidence

Substantiating your case effectively with the appropriate medical reports is a vital first step. These should entail information about your illness or injury, the treatment you've received, and the prognosis for your condition.

Workplace Documents

If your disability is related to your work or occupational duties, any supporting evidence such as workplace incident reports and emails can add weight to your claim. HR records proving a work environment unfit or harmful can also be useful.

Professional Opinions

Expert testimonies, such as those from occupational therapists or doctors, can further strengthen your case. They can provide a detailed assessment of your work abilities in light of your condition.

Personal Accounts

These statements, from yourself and people close to you, can help prove the impact of your disability on daily life and your inability to work.

Remember, each case is unique and what counts as effective evidence can significantly vary. Therefore, seeking advice from TPD lawyers, such as Smith’s Lawyers, is advisable for guidance on the type and amount of evidence needed in your particular case. With Smith's Lawyers, initial advice is free and all claims are run on a risk free basis with no upfront costs.

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The Importance of Seeking Legal Advice for TPD Claims

Most people are unaware of the complexities involved in making a Total and Permanent Disability (TPD) claim. The intricacies of insurance policies, the criticality of detailed evidence and the technicalities of legal writing can present daunting challenges for the inexperienced claimant, which highlights the significant benefits of utilising a TPD claim lawyer.

Insurers often employ resourceful ways to deny claims. Their vast knowledge and intellectual capital focused towards remediation of any potential losses, leaving claimants at a disadvantage. In this unequal power dynamic, the role of a TPD lawyer becomes pivotal. Employing a TPD lawyer who understands the intricate details of insurance policies can save your claim from being expunged in the first instance. Their competence in compiling robust, compelling and detailed applications can increase your chances of success exponentially.

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Extremely helpful company in consideration of the outcome these people have helped me with I recommend these lawyers to any struggling or successful individual.

Jamie Mann
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The experience dealing with Smith’s Lawyers has been a pleasant affair. Working with me they were able to secure payments for my recovery after being accidentally struck by a vehicle. Although a horrible experience to go through, I was not alone and had smith’s navigate to an amicable outcome.

M Joseph
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Very professional, helped me out a lot and went above and beyond with things they didn’t need to, highly recommend.

Mitchell Hearn
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Very very happy with outcome of my case with Smiths Lawyers my solicitor Juliet was fantastic at her job and got me through to the end with her honest reliable advice on my matter All the staff at Smiths Lawyers are always so supportive and pleasant to deal with. Fantastic group of people that care about the clients

Harry Butler
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Thank you to Yasmine Chalvatzis, Vivian Lee, and to their supportive team members in helping me through this difficult trying time. I am very grateful for their assistance, and happy with the final outcome. I would also like to thank Jeremy Wiltshire, Barrister-at-law, who along with Yasmine, helped to bring a resoluti

Raymond McKenzie
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Absolutely fantastic service from the team at Smith’s from start to finish. Emily was amazing in communicating everything, making sure I was aware of everything and was well informed before making decisions. She took the time to explain the ins and outs of my case and made sure to ease my mind with every concern I had.

Hayden Wilson
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What a beautiful experience to have worked with Smith lawyers! Such a kind and trusting company. I worked with Emily on my case and am blown away with her work and kindness. Very happy! Thank You so much.

Bhodi Wells
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The customer service from Kay and Stephen was outstanding. They made the entire process easy to understand and were always happy to answer my questions. Highly recommend Smith's Lawyers.

Nadia Maartens
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I would like to thank smith's lawyers and especially Stephen for the hard work for my TPD claim. Having you to take the pressure off in this whole accident has been a great relief. I highly recommend to anyone seeking help to contact Stephen and kay at smith's lawyers. Thanks again so much.

Tammy McGowen

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TPD Claims FAQ's

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Can you make multiple TPD claims?

Yes, this can be possible. Commonly, individuals who have experienced severe injuries or illness might be members of multiple superannuation funds. If this is the case, these individuals may indeed be able to make multiple claims for TPD insurance. The ability to file multiple claims hinges on how many active superannuation funds the individual has.

Here are few factors to consider: 

  • Membership to multiple funds: If you're a member of multiple superannuation funds, and each of those funds provides TPD cover, you may be eligible to claim against each policy. This can provide a significant financial safety net in case of severe illness or injury.
  • Policy terms and conditions: It's essential to read through the terms and conditions of each policy as some may have exclusions or restrictions that could impact the ability to make multiple claims.

Given that each case is unique, it is strongly advised to seek legal guidance when considering multiple TPD claims. Smith’s Lawyers, with our "No Win. No Fee. No Catch" promise, are experienced in navigating these complexities and ensuring your rights and entitlements are upheld.

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Will a TPD claim use up my Superannuation balance?

The short answer is no. A widely-held misconception is that making a TPD claim will cause one's superannuation to prematurely run dry. However, TPD claims an insurance policy and the money’s payable are separate from the retirement benefits in your Super account currently.

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Are there any upfront costs or risks if the claim is not successful?

Absolutely none. We don’t charge any upfront costs to run the claim and only charge a fee if your TPD claim is successful. In the event it’s not successful then there is nothing to pay with our industry leading No Win, No Fee, No Catch® promise.

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Appealing a Denied TPD Claim: Know Your Options and Rights

Experiencing a denial of your TPD claim can be a disheartening event. However, it's crucial to comprehend that a denial is not necessarily the end of the road. There are several options available to you in such an eventuality. 

  • Requesting a Reassessment: Most superannuation funds allow you to have your claim reassessed. This typically involves submitting additional documents or medical evidence to support your claim.
  • Seeking a Dispute Resolution: If reassessment does not produce the desired outcome, it may be worth pursuing a dispute resolution process, often provided by the Complaints Departments of super fund insurers.
  • Formal Legal Action: If unsuccessfully reassessed and having undergone resolution measures without success, taking formal legal action could be an option. This typically involves a TPD claim being brought forward in the court system.

Remember, these pathways do not assure victory but can potentially transform an initial denial into a favourable result. Always seek the assistance of skilled professionals, such as Smith's Lawyers, who are familiar with the claims process and your rights. Their 'No Win. No Fee. No Catch' promise ensures you remain risk-free as they guide you through your appeal.

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TPD Claims vs. Other Compensation Options

If you've sustained an injury or experienced illness, it's worth bearing in mind that TPD claims are not the only option available to you. 

Smith's Lawyers understand the complexity of compensation law and recognise that every situation is unique. Therefore, they explore every legal avenue to optimise your potential compensation. For instance, if you were injured in a car accident, you might be eligible to lodge a common law car accident injury claim, in addition to or as an alternative to pursuing a TPD claim. 

Check your legal options with a free case review today.

Get expert advice today

To check your compensation entitlements, request a free case review with our expert workers compensation lawyers. We can explain your options to TPD claims so you are clear on your rights during this difficult time.

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