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Can you make a TPD claim for depression?

People often associate total and permanent disability (TPD) with illness or physical injury. As a consequence, many don’t think it’s worth claiming TPD for mental health issues because the process seems more difficult to navigate and the illness harder to prove and get approved. This article will demonstrate that this is not the case and highlight the steps you can take to claim TPD for depression and mental health issues. 

Filing TPD for depression and mental health

The stipulation for TPD is that you are totally unable to return to work and you need TPD cover because you cannot fulfil your duties at your job either permanently or temporarily. However, the cause of your mental illness does not affect your eligibility to file, and the caveat to receiving compensation is proving that you do not have the capacity to work to the level you once did or at all. 

Some TPD mental health injuries that can be claimed include:

  • Anxiety disorder
  • Depression
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Schizoaffective disorder
  • Borderline personality disorder
  • Schizophrenia
  • Obsessive-compulsive disorder

Unlike claims for other benefits through TPD, such as a loss of a limb, mental health disabilities primarily focus on your capacity to work due to your illness. What this looks like for a mental illness claim is the inability to complete tasks due to your mental health. 

Claiming for TPD related to mental illness and depression can be difficult, but it’s not impossible. Like other disability benefits claims, you will need to provide medical evidence of your progress throughout the illness and proof that you are receiving regular treatment. This can include records from your psychologist or psychiatrist. The important part of claiming TPD insurance with a mental illness like depression is delivering proof that you are supported by a medical professional. 

However, seeing a medical professional can be difficult if you live in a rural area or have limited access to treatment because of transportation or financial needs. The cost of treating depression and other mental health issues can be high and can even prevent people who live in a city from seeking help. 

In this case, you should still seek a note or recommendation from your general practitioner (GP) as a sign that you have support from a medical professional. This will help the court or insurer support your claim and provide you with compensation.  

Your superannuation will cover your psychological condition claim whether you are employed, self-employed or employed by the state. Keep in mind that you may have multiple policies and you can file a separate claim for each.

How does a TPD claim work?

Your TPD claim will start, ideally, before you ever need it, with your superannuation fund. Checking to make sure your insurer covers your mental health condition will be your first step toward filing a claim. You may have multiple superannuation funds if you’ve worked several jobs in the past. 

Insurance will cover your psychological injury whether you cannot work your current job or any potential future jobs because of your disability. TPD will also cover you if you are unable to work in any occupation at all. 

If you are unable to work, TPD cover’s goal is to help you carry on as normal to the best of your ability despite a halt to your income. TPD insurance can for instance cover your medical bills, medication and debts. 

How long does a TPD claim take?

Depending on your individual circumstances, a TPD claim should be resolved within two to three months of submitting the relevant forms and documentation. This includes a complete review of the TPD discharge application. If there are any discrepancies or errors, the process could be pushed back. 

You can receive payment as a lump sum, through a partial withdrawal from your super or by leaving the entire balance in your super. 

It’s helpful to work with TPD lawyers for this claim because making the claim involves a series of steps and documentation that could result in a denial of your insurance cover if not completed properly. It’s also recommended to send a note of intent with the application, which should be written by a law professional for formality and clarity. 

Steps necessary to file a claim

If you are claiming through your superannuation fund, here are a few steps you’ll need to take to successfully file a mental health insurance claim:

  1. First, you have to reach out to your super fund for the necessary documentation. You will need your personal identification, medical records and documentation.
  2. The fund will give you an application that will need to be filled in completely and signed by you. 
  3. A case manager will be assigned to you to look over your paperwork and documentation. They will determine whether you are eligible based on your application, documentation and a recommendation from your past employer. 
  4. An insurance provider will also examine your paperwork and will determine if more information is necessary before approval. 
  5. If your claim is accepted, you will discuss payment options. If it is deferred, the insurance provider is still looking over your case. And if your claim is denied, you will need to file again. 

If you file separately, your process will look similar but not exactly the same:

  1. Your insurer’s claims team will have the claim documentation you need to fill out.
  2. You will prepare your documentation including your claim paperwork, records and bank details of your nominated account.
  3. You’ll then submit your claim to the insurance provider.

A lawyer can help you win TPD benefit

Hiring a lawyer can help you understand your rights as someone suffering from mental health issues and who is unable to work. A lawyer can offer legal advice to you and recourse should the insurer deny your claim for any reason. There are times, too, during the claims process when the insurer will not approve you for enough compensation to cover your everyday needs. In these cases, it’s important to seek professional intervention. 

In addition to the legal challenges of a TPD claim, facing legal proceedings on your own can be hard to cope with. On top of managing your mental illness and realising you no longer have the capacity to work in your particular field or at all, the strain can be devastating. A lawyer can help you navigate the system and get you the compensation to which you are legally entitled. If you are ready to pursue a TPD claim through your superannuation fund, Gerard Malouf & Partners is here to help. We provide a no-obligation consultation where you can ask questions and we’ll go over what you’ll need to do to receive benefits. We are the leading Australian no win, no fee law firm for TPD claims and specialise in maximising the compensation results from your claim.

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 — Personal Injury Compensation Lawyers

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