What criteria must I meet to make a successful TPD claim?
Published 10 Dec 2018
Author: Gerard Malouf
It’s one thing lodging a total permanent disability (TPD) compensation claim – it’s another being successful, thanks to the criteria individuals have to meet as an entry threshold.
Here we breakdown what a TPD compensation claim is and the five key criteria applicants need to consider to achieve a favourable outcome.
What is a TPD claim?
TPD claim payments provide financial support for those no longer able to work in their occupation following a mental or physical injury. Making the case for compensation requires the injured individual to file a TPD claim through their superannuation fund provider or insurer and have their application analysed by an experienced claims assessor.
This expert will look out for five key criteria that play a role in determining whether or not the compensation claim is successful.
The five factors that determine successful TPD claims
1. Level of disability
The level of disability suffered as a result of injury is a major determining factor from the outset. The claims assessor will consider questions such as if:
- You are able to return to your prior occupation.
- You can return to any form of employment in the future.
- Your disability stems from losing a whole or part of your limbs, eyesight or other senses.
2. Superannuation cover
Major injuries that lead to permanent disability are often not covered in your superannuation because of the difference between ‘any-occupation’ and ‘own occupation’ disability. The difference is that any occupation is defined as any job matching your basic level of experience and training, which can be difficult to prove long-term. Own occupation meanwhile, provides cover in the case of injury stemming from working in a specific role or organisation.
3. Minimum work history
Certain insurers require injured individuals to meet minimum work history requirements in order to qualify for TPD compensation. These include:
- A minimum of 12 months’ working history, which the claimant must be able to demonstrate through presenting contracts or other signs of employment.
- Whether the work performed was under full-time or part-time basis.
- The number of hours worked in total at the time of injury.
4. Ability to perform daily tasks
Some TPD repayment policies that provide assistance with increased day-to-day living expenses require individuals to demonstrate that they cannot perform basic living activities. These include, but aren’t limited to, walking, bathing and eating.
5. Need for ongoing medical care
Other factors in TPD compensation claims require the injured to prove that they are in need of ongoing medical care thanks to the effects of their debilitating injury. Individuals can meet this criteria by showing appointments for medical appointments or rehabilitation.