How are total and permanent disabilities assessed?

Published 01 Mar 2017

Suffering an illness or injury may require you to take a considerable amount of time away from the workplace. This can have a significant effect on your confidence, financial situation and career.

Particularly serious problems could prevent you from ever returning to your job, or at least stop you from performing in the same type of role. If this is the case, you may have a total and permanent disability (TPD).

Insurers and superannuation funds often provide compensation for TPDs as part of certain policies, but claimants must meet specific criteria before their provider will pay out.

What criteria must I meet?

Every policy has different stipulations, making it crucial that you check your paperwork to see how much coverage you possess. These policies can cost insurers and funds millions of dollars in lump sum payments to a single claimant, so organisations will stick to their terms and conditions rigidly.

However, in our experience, there are several criteria that are common to many TPD policies. Typically, you must be:

  • Incapable of working in any employment - either due to sickness or injury - for which you have reasonable experience, education and training;
  • Currently out of work due to your injury or illness;
  • Under 65 years of age on the date you stopped working; and
  • Covered by an insurance policy on the date you ceased employment.

There are several other factors that insurers and superannuation funds will consider before ruling whether you are eligible for a payout or not.

Will my claim be successful?

It's not possible to guarantee the success of a claim, but a superannuation disputes lawyer can discuss your situation and advise you on the best course of action.

Before making a claim, you usually have to be unable to work for a certain period of time - most policies specify six months. You will also require statements from medical practitioners in support of your case.

It's important to remember that while alternative employment may be available, you might still be eligible to make a claim. This is particularly true if you are required to retrain or upskill for new positions. 

Furthermore, attempts at returning to the workplace following your accident or illness shouldn't prevent you from pursuing compensation if these efforts were unsuccessful. 

Would you like to know more about TPD claim eligibility? Please contact Gerard Malouf & Partners Superannuation Lawyers for further information.

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