It can be financially burdensome if you are unable to work. Car accidents, workplace accidents and serious illness are unexpected and can leave you with permanent illness or injury that prevents you from being able to work. Thankfully, if you are eligible and have TPD Insurance cover in your superannuation policy, you may be entitled to claim a TPD payout to assist ease the financial burden.
However, the TPD definition that will determine your eligibility is based on when you ceased work. Here we set out to provide you with information about the different TPD definitions that apply and when they apply. If you require more information or a guide on how to make a TPD Claim feel free to find out more here.
TPD definitions
Most commonly, there are three (3) TPD definitions – any occupation, own occupation and activities of daily living.
TPD stands for total and permanent disability. A TPD insurance benefit is a lump sum (or instalment) payment through your superannuation fund.
You may be entitled to make a TPD claim through your fund if you are unable to work due to illness or injury.
While most TPD definitions across different funds are similar, each fund has its own requirements that you need to fulfil to make a successful TPD claim. Additionally, your fund may have multiple TPD definitions with the hardest one to meet being if you were not working within 12 months from the date of your inability to work.
Your ability to make a TPD claim will depend on how the insurer defines TPD in their policy and whether or not you were working within 12 months from the date of your inability to work. For example, if you ceased work more than 12 months then you sustained the disability to work, the definition of TPD that you must meet will probably be the activities of daily living TPD definition. Our TPD Lawyers have helped thousands make successful TPD claims so feel free to reach out to us for a free eligibility claim check.
Any occupation TPD definition
The most common TPD definition is the any occupation definition which requires that you satisfy the following:
- You stop working, or are unable to work due to injury or illness;
- You do not work for at least three or six months consecutively;
- After the three (3) or six (6) month period, it is unlikely (or you are unable) to return to work in any occupation that you are reasonably suited to by your education, training or experience.
Own occupation TPD definition
The next most common definition is the own occupation definition. In some instances, a TPD definition may require that you satisfy 1 and 2 above, however that you are unlikely to return to work in your own occupation. What own occupation means is often a topic of dispute however, the policy usually provides further guidance as the meaning of own occupation. In some instances own occupation refers to the occupation that you were doing at the time of obtaining the policy, and at other times, it may refer to your occupation in the lead up to you ceasing work.
Activities of daily living TPD definition
More recently, some superannuation funds are making it more difficult to claim a TPD payout by imposing ‘Activities of Daily Living’ (ADL) test depending on your circumstances at the time of being unable to work.
An ADL test is whether you are unable to do two (2) or more basic tasks such as bathing, dressing, feeding, going to the toilet and transferring yourself in and out of bed. If you are unable to perform 2 or more of the above tasks, and your TPD definition requires that you satisfy the ADL test, then you may be eligible to make a TPD claim.
As you can see, it is a more difficult definition to satisfy than the any occupation or own occupation definitions.
TPD definition will explain whether your TPD payout is a lump sum or instalments
What the definition is will determine whether you will be eligible to make a claim and also how that claim will be paid to you. Most policies make a lump sum payment however, others pay the TPD benefit in instalments over a period of time. If this is the case, you will most likely be required to demonstrate your ongoing inability to return to work by providing your fund (or insurer) with medical evidence for your total and permanent disability each year.
There are certain circumstances that apply in order to apply to have all the payments made. Please contact our TPD Lawyers for a free eligibility claim check whereby our TPD Lawyers will inform you of your eligibility to make a claim, processing time and process involved all on a No Win No Fee basis.
Other TPD definitions
While there are many funds that use the most common TPD definition, it is impossible to list here all of the TPD definition types and therefore, it is important to treat each matter on a case by case basis. Determining whether you are eligible to make a TPD claim can be difficult, particularly if you are already struggling with physical and/or psychological symptoms. If this is you, or you would like some free advice regarding:
- your eligibility to make a TPD claim;
- which TPD definition will apply to your claim
- making a successful TPD claim; or
- challenging a refused/denied TPD claim
call our TPD lawyers on 1800 952 901. We have extensive experience with thousands of TPD claims and therefore, are familiar with what TPD definitions mean and what is required for you to make a successful TPD claim as efficiently as possible. Our experienced TPD lawyers can make this easy for you by taking the guess work out of your eligibility and preparing your claim thoroughly on a no win no fee basis, giving you the best chance at getting your TPD payout.
Case Study – Significant wrist injury for carpenter leads to TPD payout
Robert, aged 43, sustained a serious right hand injury after his fingers were severely injured while at work. Robert is right-handed and worked as a carpenter his entire working life. He has no other qualifications, education or experience in anything else.
Withstand Lawyers handled his workers compensation claim and referred him to our experienced TPD lawyers who advised him in relation to his possible entitlement to a TPD payout.
Robert was of the view that because his injury only involved his hand, a small part of his body, that he would not be entitled to claim his TPD benefit.
Robert’s lawyer reviewed his superannuation statement and identified that he held TPD insurance cover. Robert’s lawyers also identified that Robert had another superannuation account where he held TPD cover that he had forgotten about. After further review of Robert’s TPD definitions and requirements, they advised Robert that he satisfies the definition and that he had reasonable prospects of success. Robert was pleased as he had been feeling anxious about his financial struggles and was not expecting to be eligible to make a TPD claim.
It was established that Robert had stopped working eight (8) months ago and was unable to work due to his hand injury. Robert’s TPD lawyers obtained supporting medical evidence from his treaters in line with the requirements of his TPD policy, which established that it is unlikely that he would return to work in any occupation that was suited to him by his education training or experience, as he had only ever worked and studied carpentry.
Robert received a combined total of $683,000 from his two TPD claims. Contact us today for a free eligibility claim check and have peace of mind that our TPD Lawyers work on a No Win No Fee basis.
Issa Rabaya
• Bachelor of Laws
• Graduate Diploma in Legal Practice
• Approved Legal Service Provider to the Independent Review Office
• Member of the Law Society
