In Australia, when you can’t work again in your usual occupation because of an injury or illness, you can make a total and permanent disability (TPD) claim through your superannuation fund. Generally, any medical condition that stops you from working can qualify as TPD, regardless of whether you have a mental illness or an unexpected illness or injury.
This ultimate guide will take you through every aspect of making a successful superannuation TPD claim, helping you secure your financial future during tough times.
Key Considerations
- To understand superannuation TPD claims, you must know the eligibility requirements and the complex claim process.
- Hiring a TPD lawyer helps reduce stress and substantially increases your chance of success, with AIL working on a 100% no win, no fee basis, with capped or fixed fees.
- A typical payout ranges from $50k-$500k, with some fortunate people eligible for multiple TPD claims (depending on factors).
About Superannuation TPD Claims
TPD insurance is designed to provide financial support through a lump sum payment, known as a TPD benefit, for Australians who can’t work due to an injury or illness. Many workers don’t know this coverage is included in their superannuation fund. Thankfully, you can access this valuable insurance benefit when you can’t earn an income.
But how do you know if you’re eligible for a TPD superannuation claim, and how do you work through the often-complex claims process? We will explore the fundamentals of TPD claims and how they interact with your superannuation.
What is TPD Insurance?
In Australia, TPD insurance pays a lump sum payment when you meet the definition of being ‘totally and permanently disabled’. As a result, you may have a successful TPD claim if an illness or injury prevents you from working in your primary occupation or any other job for which you are qualified due to your education, training, or experience. And it’s not just for physical injuries. Mental health conditions and psychological illnesses that disrupt your work capacity also qualify for a TPD claim. In this case, you would be eligible for a TPD insurance claim.
What is Covered by TPD Insurance?
Every insurance company and super fund insurer has a different definition of total and permanent disability, but there are generally three main categories.
- Own occupation: you can’t work again in the role you were doing before your disability. This TPD insurance cover is typically costs more and unavailable through a superannuation provider.
- Any occupation: you can’t work again in any role suited to your training, education, or experience. This cover is usually cheaper but harder to claim.
- Activities of daily living: this definition is not based on your job. Rather, it assesses your capacity to care for yourself and lead an independent life.
Each category has distinct criteria; therefore, grasping your insurance policy’s specific TPD definition and satisfying these criteria is the key to successful TPD claims.
Am I Eligible to Make a Superannuation TPD Claim?
To be eligible to make a TPD superannuation claim, first, you need total and permanent disability (TPD) insurance included with your superannuation policy (or a stand-alone insurance policy) on the day you stopped working (or when your permanent disability rendered you unable to do your role or one for which you have training or experience).
Thankfully, our specialist superannuation lawyers will investigate your disability insurance cover for free and help you know your options (including if you can make multiple TPD claims) Call Now – 1300 873 252
Can I Make Multiple TPD Claims?
You can make multiple TPD claims when you have insurance with multiple super funds. Some fortunate Aussies have contributed to more than one superannuation fund and, hence, have multiple disability policies. Typically, you can make a separate claim against each superannuation insurance policy in this situation.
Please be aware that each insurer’s terms and conditions will differ, including their Total and Permanent Disability definitions. Sometimes, one claim will succeed while another is disputed or rejected. For this reason, the support of an experienced TPD insurance claim lawyer will likely give you the best chance of the result you seek.
Know if you can make multiple claims and their value by calling 1300 873 252
Next, we take a closer look at TPD eligibility requirements.
Assessing Your Policy’s TPD Definition
Before making a TPD claim, it’s crucial to understand the TPD definition in your insurance policy, as it determines your eligibility for a payout. The TPD definition varies among policies, with some covering you if you can’t return to your pre-injury occupation, while others apply if you can’t perform any kind of work. Recognising these differences will help you create the necessary supporting information and evidence to support your claim.
Reasonable Retraining
The “retraining clause” is another important aspect of the TPD definition to consider. Under the TPD definition of most Australian superannuation funds, you must be unable to find employment in your usual (or any) occupation for which you are reasonably qualified by experience, education, or training, allowing for the restrictions caused by your injury or illness.
The reasonable retaining clause states that even if you receive reasonable retraining that takes your disability into account, you still won’t be able to return to work. For this reason, insurance companies will ask for detailed information about your current job description, work history, and past vocational training. Knowing how this works is another factor in having a winning outcome.
How Hard is it to Prove TPD?
When claiming TPD through your superannuation provider, you are responsible for proving you have a total and permanent disability for the purposes of your insurance policy definition. Please remember that this definition is not the same as proving you have a permanent disability when claiming NDIS or Centrelink benefits.
The superannuation trustee has a responsibility to aid in communication with the insurer and confirm a satisfactory resolution has been achieved. If the trustee disagrees with a decision, they should help with the dispute resolution procedure. In reality, there are significant differences in the behaviour of superannuation trustees, which is why a skilled TPD litigation lawyer can assist in getting your best outcome.
The Super TPD Claim Process
Successfully lodging a TPD claim can be difficult, but with expert legal support, it can be less stressful. Here is the step-by-step TPD claims process for winning insurance benefits:
Consult With a TPD Lawyer
Hiring a TPD lawyer can greatly improve your chances of a successful claim. That’s because specialist TPD lawyers have substantial expertise when:
- Locating old superannuation funds & insurance policies
- Checking for TPD insurance coverage
- Negotiating settlements with large insurers
- Championing your rights if you have a rejected claim
With their expertise and support, you’ll be better equipped to navigate the claims process and maximise your payout.
Remember, when selecting TPD lawyers, discuss legal fees before proceeding so there are no nasty surprises. Aussie Injury Lawyers work on a 100% No Win, No Fee basis, which means you pay legal fees when you win and zero if you lose. Plus, we will give you an upfront, capped, or fixed price before we start work on your case. Get a quote now >
Collate Medical Evidence
Substantiating TPD insurance claims requires compelling medical evidence documenting how your injury or illness impacts your work capacity. This evidence typically includes medical records and reports, assessments, and other documents demonstrating how your illness or injury satisfies your insurance policy’s terms.
Furthermore, regular consultations with medical professionals, like general practitioners, psychologists, or psychiatrists, will help support your case when making a mental illness permanent disability claim.
Lodge Your Claim
To trigger the TPD claim process, you’ll need to follow these steps:
- Contact the superannuation fund and request the relevant claim forms.
- Populate the forms with information about your medical condition, employment history, and any other relevant details.
- Providing honest, accurate, and thorough details is essential, as any errors or omissions could delay your case or cause a claim denial.
- Attach a supporting letter explaining why you should have an approved insurance claim.
After submitting your claim forms, your superannuation fund will assess your documentation to determine if you qualify for a TPD payout. This process can take several months, so it’s important to be patient and follow up with your super fund to ensure they have all the necessary information.
TPD Payout or Denial
Once approved, a lump-sum payout will be deposited into your superannuation account, substantially boosting your retirement funds. The decision to withdraw, transfer, or postpone withdrawal is then yours. If you have a rejected claim, your lawyer will work with you to challenge the outcome and reverse the insurer’s decision.
Common Types of TPD Claims
You can make a total and permanent disability claim for many different medical concerns. Generally, any physical injury, illness, or psychological disorder that stops you from working in your regular job can qualify for a successful TPD claim. These are some of the most common kinds of TPD claims in Australia.
| Examples of physical injuries that qualify for TPD | Chronic back pain Spinal cord injuries Head and brain trauma Loss of Vision, Hearing or Speech Shoulder injuries Lower limb damage Loss of limb Paraplegia and Quadriplegia |
| Examples of mental health issues that qualify for TPD | Depression Anxiety PTSD Schizophrenia Bipolar Disorder Borderline Personal Disorder Any other recognised and diagnosable psychological disorder |
| Examples of illnesses and diseases that qualify for TPD | Most Types of Cancer Multiple Sclerosis Dementia Motor Neurone Disease Muscular Dystrophy Alzheimer’s and Parkinson’s disease Chronic lung conditions Severe Arthritis Heart Attack and Stroke |
The list above serves as a general reference. Please check your TPD policy terms or contact our friendly insurance experts to find out if you have an eligible claim. It’s free to understand your circumstances.
More about the common types of TPD claims >
Examples of Common TPD Claim Situations
The following are some frequent situations that may result in a successful TPD claim.
| Permanent Injury or Illness | When a permanent injury or illness results in an inability to work, you could claim TPD entitlements. This includes physical injuries like limb loss, spinal injuries including paralysis, and recognised mental illnesses like depression and anxiety. |
| Work Accidents | You may be entitled to workers compensation and a TPD benefit payout when the unexpected happens, and you are seriously injured in a work accident. Typical workplace incidents include slips, trips, falls, industrial accidents, or work-related illnesses. |
| Serious Illness | If you suffer from a terminal or debilitating illness, you can make a successful TPD claim. Chronic conditions include fibromyalgia, cancer, multiple sclerosis, and other severe medical conditions. |
| Hospital Isolation | If you are hospitalised due to a long-term illness or injury that stops you from working, you can win your TPD payout. |
Tips for Maximising Your TPD Claim
When seeking to maximise your TPD claim, remember a few essential tips.
- Please provide as much evidence as possible to support your case. This would include your medical records and any other documentation that can help prove your case.
- Be honest and transparent, ensuring your claim is accurate and consistent to increase your chance of receiving compensation benefits.
- Seek professional assistance from a lawyer or TPD specialist. Your legal team will provide valuable guidance and support, ensuring you have the best chance of success.
- Be patient and persistent. Claiming TPD benefits can be a lengthy process, but with the right approach and mindset, you will increase your chance of successfully receiving your deserved compensation.
4 Common Mistakes to Avoid When Lodging a TPD Claim
1. Misunderstanding the Definition of TPD
Misunderstanding the definition of TPD is one of the most common errors people make when lodging a TPD Claim. Total and Permanent Disability (TPD) is a medical condition that stops you from working in any occupation for which you have experience, education, or training. This means that even if you could work in another industry, if your disability prevents you from working in your chosen profession, you may be eligible for a TPD payout. To avoid this mistake and increase your chances of success with your TPD claim, ensure you fully understand how your disability insurance policy defines TPD.
2. Waiting Too Long to File Your Case
One of the most common mistakes people make when filing a TPD claim is waiting too long. Although there is typically no deadline for submitting a case, delaying lodgement may decrease the likelihood of a favourable result. There is a higher likelihood of insurance companies disputing the severity and effects of a physical or psychological condition if there is a significant delay in seeking TPD benefits.
Please act quickly and submit your super claim as soon as possible to ensure you get all the benefits you deserve.
3. Providing Insufficient Medical Evidence
When filing a TPD claim, you must provide sufficient medical evidence to support your case. These documents include a detailed assessment from your treating physician that clearly states the extent of your injury or illness and how it impacts your capacity to work. Provide adequate medical evidence to avoid the denial of your claim or a lengthy delay in getting approval. Another mistake some people make is not disclosing their entire medical history or any pre-existing conditions that could impact their outcome. Be honest and upfront about all aspects of your health when making a TPD claim, as this will increase your chances of a successful lump sum payout.
4. Not Choosing the Best TPD Lawyers
Not choosing the best TPD claim law firm can be a costly mistake. Do your research to find a lawyer or solicitor with substantial experience in winning TPD payouts. Look for testimonials and reviews from previous clients, and ask for several references. Please know that Aussie Injury Lawyers specialise in one area of law – insurance claims, with a 99% success rate.
Dealing With Rejected Claims
About 20% of Australia’s TPD claims are rejected annually. If this happens to you, please don’t panic, as you can contest the insurer’s decision and have a successful outcome. Some common reasons for rejection include:
- The insurer does not believe you meet the TPD definition.
- An inactive policy
- Not meeting the specific TPD requirements in your policy.
Appealing a rejected claim typically involves submitting a written request for an internal review, after which the insurer will review the decision and provide a response.
However, your best strategy is to engage a TPD lawyer early in the claim process, as they have the knowledge and expertise to ensure you satisfy your total and permanent disability definition and all other requirements in the first instance. Being well-prepared will mean faster access to funds and a reduced risk of a rejected claim.
Superannuation TPD Claim Payouts
Once you have an approved claim, a lump sum TPD payout will be deposited into your super account on top of your existing balance. But how much will you receive, and how can you access your funds?
More about TPD payouts >
Typical TPD Payout Ranges
The amount of money you are entitled to for a TPD payout depends on the value of your superannuation insurance policy. Based on our many years of experience with successful claims, you could receive between $30,000 and $500,000. Some fortunate people who are eligible for multiple TPD payouts receive millions.
How to Access Your Payout
Once your TPD lump sum is deposited into your superannuation account, you can choose whether to make a full or partial withdrawal or keep the money invested in your superannuation fund until retirement. Depending on the specifics of your superannuation fund, there may be different procedures for accessing your TPD compensation. Please get tax guidance before making a choice because how you handle this money will impact whether it is considered to be taxable income.
More about tax on TPD payouts >
What Can Delay a TPD Insurance Payout?
Several factors can delay a TPD insurance payout, such as an insufficient medical history or failure to provide proper evidence of your disability. Accurately presenting the extent of your impairment is critical when making a claim, as it helps ensure you receive the maximum amount of compensation available. Other common reasons for delays include inaccurate policy information or incomplete paperwork.
To ensure you have a quick and fair claim, you must have an experienced disability claim lawyer supporting you. They will guide you through the claims process and provide professional advice, ensuring you are fully prepared for unexpected challenges.
Successful Super TPD Claim Case Studies
QSuper Denied Claim Reversal
Emma had initially submitted a TPD claim for bipolar disorder with QSuper. This leading Australian super provider had taken six months to assess her case before rejecting the claim, causing significant emotional distress. Emma then had an unsuccessful appeal with the Australian Financial Complaints Authority. Aussie Injury Lawyers then took over her matter (on a 100% no win, no fee basis) and arranged an independent medical examination. Based on this report, we submitted a formal complaint to the insurer, had the decision overturned, and Emma received a payout of $500,000.
Successful PTSD TPD Payout
Jim, a school teacher in Tasmania, witnessed the horrific jumping castle accident on 16th December 2021 and suffered PTSD as a result. Consequently, he struggled to work as he felt his life had been “stolen from him”. Jim agreed to work with our skilled compensation legal team in March 2023, and in August, he received TPD compensation of more than $388,000.
Brain Injury TPD Settlement
Steve, a security worker, was born with hydrocephalus, which is a medical condition causing excess fluid buildup in the brain. Sadly, his medical condition meant he could no longer work by the time he was 46 years old. Aussie Injury Lawyers prepared and lodged his claim in August 2023, and six weeks later, he received a payout of over $230,000.
The Impact of TPD Superannuation Claims on Taxes and Benefits
While TPD payouts are not generally considered taxable income, a lump-sum withdrawal from your super fund will typically result in taxes being applied. However, if you leave funds in your superannuation account until retirement, you will likely pay no tax on your TPD lump sum.
We recommend consulting with an accountant or financial advisor before deciding how to spend your insurance benefit to minimise your tax liability.
Centrelink and Other Government Benefits
A TPD payout generally won’t impact your Centrelink payments if the funds are held within your super. However, if you choose to withdraw, it could affect your Centrelink benefits and other government financial assistance. If this is your situation, please seek professional advice to understand the potential impacts on your Centrelink disability support pension or other benefits. Reporting any changes to your financial situation, such as receiving a TPD payout, is crucial to ensuring you receive the correct amount of Centrelink funds.
How TPD Lawyers Help with TPD Insurance Claims
Hiring the best TPD lawyers for your super TPD claim is essential for a winning outcome. When seeking legal representation, please choose a law firm with experience handling similar cases and a winning track record.
Be assured that when you choose Aussie Injury Lawyers for your TPD claim, you are accessing more than 100 years of combined insurance litigation experience with a 99% win rate. Our expertise is your guarantee of a positive outcome. Furthermore, all our insurance claim legal services have 100% No Win, No Fee legal funding, which means you owe us nothing until we win your case, and nothing if lost. Hence, you are free of financial risk with AIL. To start, Call 1300 873 252 or email us >
TPD Compensation Claims FAQs
How long do TPD claims take?
On average, the period of time for a successful TPD claim ranges from 6 months to a year. However, this timeframe can vary depending on how quickly your insurance provider processes your paperwork and if they require additional information. Generally, your best strategy for success is a swift and expert legal intervention to increase the likelihood of a positive outcome.
What is the average TPD payout?
The average TPD payout is between $30,000 and $500,000, with some people claiming multiple claims worth millions.
How does TPD insurance work in super?
TPD Insurance through superannuation is a type of disability insurance cover that pays you a benefit if you suffer an extended injury or illness and become permanently disabled, making it unlikely for you to work again. Before claiming a TPD benefit, you must check your terms and conditions to understand the requirements for meeting your disability definition.
How do you successfully claim TPD?
To successfully claim TPD, you must understand your policy terms, gather medical evidence, accurately complete the form, submit the claim and wait for approval. If accepted, you will receive a lump sum payout that could ease the financial burden of your injury or illness.
How long do you have to be off work to claim TPD?
You typically need to be off work for three to six months before you can make a TPD claim. This ‘waiting period’ will change depending on your policy terms, but once it expires, you can make a claim at any time.
What do lawyers charge for TPD Claims?
How much lawyers charge for TPD claims depends on their pricing structure. Aussie Injury Lawyers is a 100% no win, no fee law firm, which means you pay costs when you win and zero if you lose. Plus, we give you a fixed or capped price before we start work on your case. Get a free quote now >
Can I go back to work after a TPD Claim?
You can return to work after a successful TPD claim in specific circumstances, depending on your insurance policy’s terms and conditions and other variables. There are generally two main categories of TPD insurance policy terms.
- You can’t return to work in your own occupation
- You can’t return to work in any occupation
The first type means you can’t do your regular job but could train to work in a different industry. The second type is more difficult because it means you can’t work in any occupation. The one exception is when innovative therapy aids your recovery to the point where you can resume employment, in which case you could return to work and keep your TPD benefit payout.
