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How to win a TPD claim

An incident that leads to what can be classed as a total and permanent disability (TPD) and prevents you from working can qualify you for compensation of different types from different sources. One of the main ways to get disability compensation is through a TPD claim. These claims are filed with TPD cover through your superannuation fund.

Filing a claim is the easy part, but winning a TPD claim can be trickier, especially if you have multiple TPD policies, with different rules associated with each one and different parameters for qualification. A disability claims attorney can help you successfully make a superannuation disability claim and win the compensation you deserve.

At Gerard Malouf & Partners, our team of expert disability lawyers can help you not only identify and file for a TPD payout, but can inform you if you have additional sources of potential compensation, such as a disability support pension or a workers’ compensation claim. We work with you to get every dollar you can, and we do it on a no-win, no-fee basis so you only pay us if we succeed.

Understanding what TPD is and how it affects you

A total and permanent disability is typically identified as a physical or mental disablement with at least 20% impairment. It prevents you from working and making a living the way you did before the accident or illness that left you disabled.

Your superannuation fund usually has TPD cover attached. If you have more than one super, you may also have more than one TPD policy. Some TPD insurance specifies that you must be unable to work in any job full time, while others only require that your disability prevent you from working the job you originally had before the disability occurred.

In most cases, a TPD settlement is paid into your superannuation fund as a one-time, lump-sum payment. You can withdraw the funds or a portion of the funds without penalty, even if you haven’t reached the age of being able to access your super benefits. It’s even possible you can receive this payout without tax liability.

You can use your TPD payout to cover medical costs and act as income protection while you are unable to work. The amount you can receive from a TPD claim will vary. You can receive a TPD payout from multiple TPD policies, and not impact your superannuation funds. You can also receive a TPD lump sum payout while you are filing a workers’ compensation or a disability support program (DSP) claim.

It’s wise to enlist the help of a qualified TPD lawyer before starting the process of filing a TPD claim. If you use the right disability legal firm, you won’t have to pay legal fees unless you are awarded compensation.

What's the process when making a TPD claim?

The first step if you plan to file a TPD claim is to get representation by a TPD attorney. Then you have the help you need to navigate the claims process. Some TPD claims run smoothly, especially in cases of clear and significant disability that precludes a worker from returning to the workforce for the foreseeable future. Others can get bogged down in the documentation review stage, if you haven’t built a strong case for being permanently disabled.

Next, you’ll want to contact all superannuation funds you have paid into, and find out which of them have a TPD policy, and how the TPD benefit eligibility is qualified (in some cases you may be able to file simply for having a total and permanent disability; in others, you may have to prove you can’t be retained or reskilled to take on a different job from the one you held previously.

Now it’s time to gather all of your medical documentation. You’ll need proof of your diagnosis of complete disability, plus supporting documents that show that, subsequent to diagnosis, you received treatment until your condition was declared stabilized and unlikely to improve further. If you are filing because of a mental health disability. You may also need to provide additional documentation from your mental health provider.

When you file your TPD claim, there is no set timeline for approval. However, as a rule of thumb, it takes 6-12 months for the insurance company to review and approve or reject your claim. If approved, the trustees of the super may take an additional 30-90 days to approve the disbursement. If your TPD claim is rejected, you can appeal the decision. If your disability has gotten worse, you may start over with a new claim and your new documentation.

Payouts on TPD claims can range anywhere from $60,000 to $300,000. If you anticipate never being able to return to work, you may need more support than the one-time payout from your TPD insurance can provide. Make sure you ask your legal team about filing other types of disability claims, such as a workers’ compensation claim (if applicable) or a DSP claim for ongoing fortnightly payments.

What to do if your TPD claim is rejected

Since policy criteria can vary widely from policy to policy, a rejection might be generated if you aren’t meeting the required level of disability as specifically defined by the TPD insurance policy you are filing the claim against.

If you have a short-term vs. a long-term disability, your TPD claim might be rejected on the grounds that you do not have a permanent disability. However, if you can recover somewhat from your condition but not enough to drop you below the disability rating required for a pension, you may still qualify for compensation.

Another common reason a TPD claim might be rejected is that the policy is no longer active. TPD policies can become inactive if you closed your account or if the account has been inactive for a long period of time. This is why it is so important to keep track of your superannuation funds and what cover is provided.

A TPD claim might be rejected if you haven’t satisfied minimum waiting periods or haven’t fulfilled work history requirements. Finally, a claim can stall due to the insurer disputing your evidence, saying you didn’t provide the right type and amount of medical evidence to support your claim.

Don’t panic if your claim is rejected. We can continue the claims process by filing an appeal and helping you gather more documentation. We can also pursue additional avenues to provide you with income protection, as the claims process can take six to twelve months or longer if an appeal is involved.

Should a lawyer help with your TPD claim?

Having a TPD lawyer help with your claim is a good idea for several reasons. An attorney familiar with TPD and disability claim rules can quickly identify all possible actions you can take to file for disability. This includes any and all TPD claims you may be entitled to file, as well as workers compensation claims and/or a disability support pension.

While you may feel confident in your ability to submit a TPD claim online, having a TPD attorney on board from day one can help you if your claim runs into trouble. We bring a high level of expertise to the table and have turned many floundering TPD claims around to get our clients a fair lump sum payment.

In some cases, we have managed to exponentially increase the amount of disability payments by finding potential claims to bring that our clients were unaware of, such as old supers with TPD insurance policies still in effect. On others, we identified a potential workers’ compensation claim and assigned a personal injury lawyer to follow up and see if the employer could be held liable for an accident or health condition leading to a disability.

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