Written by: Angelica Adhar Multiple sclerosis (MS) is a chronic illness of the central nervous system that can affect your ability to work, sometimes permanently. If MS prevents you from returning to work, you may be entitled to a total and permanent disability (TPD) payout through the insurance held inside your superannuation fund.
In this guide, we walk you through whether MS qualifies for a TPD claim, what counts as total and permanent disability under your policy, the evidence you need to support your claim, and how much you could receive.
Can you claim TPD for multiple sclerosis?
You can make a TPD claim for multiple sclerosis when it leaves you unable to work on a long-term basis. The claim is made against the TPD insurance policy held inside your superannuation fund, and if approved, you receive a lump sum payment.
Eligibility is assessed against your capacity to work under the terms of your policy, not against your diagnosis. Two people with MS can receive different outcomes depending on the policy they hold and how their condition affects their ability to perform their job or any suitable alternative.
Key takeaway
Eligibility for a TPD claim is not based on having MS. It is based on whether your symptoms prevent you from working in the role you held, or any other suitable role, on a long-term basis.
How much is a TPD payout for Multiple Sclerosis?
TPD payouts for multiple sclerosis generally range from $60,000 to $500,000. The amount you receive is determined by the sum insured under your policy, not by your diagnosis or the severity of your MS.
Two people with MS can receive very different payouts depending on:
- How long your cover has been in place
- Your age
- Occupation when the cover was taken out
- Whether you hold cover across more than one account.
For example, a 45-year-old teacher who joined their super fund 15 years ago on default cover may hold around $250,000 in TPD insurance, while a 35-year-old who joined a fund five years ago on the same default cover may hold only $120,000, even though both have been diagnosed with MS at similar stages.
Client story
Our client was a 39-year-old project manager diagnosed with multiple sclerosis in 2003. She managed her condition through bi-annual infusions while maintaining full-time employment for over fifteen years. Her symptoms progressed over time, and by early 2019, she had lost the ability to stand or walk without assistance and had become wheelchair dependent; then she stopped work.
GMP Law lodged a TPD and income protection claim on her behalf. The income protection claim was approved within 17 days of lodgement, and the TPD claim was approved for $400,000 within five months.
What qualifies as total and permanent disability for MS?
To qualify for a TPD payout, your MS needs to meet your policy’s definition of total and permanent disability. In most cases, that means showing your condition prevents you from working in any job suited to your education, training, or experience.
| Policy definition | Details |
|---|---|
| Any occupation | Any occupation is the definition used in most superannuation TPD policies. It requires showing that you cannot perform any suitable role, not just the one you held when you stopped working. For example, if you are a teacher whose cognitive symptoms and fatigue mean you can no longer manage a classroom, you would need to show you are also unable to perform reduced or sedentary work you would otherwise be qualified for. |
| Own occupation | Some policies use own occupation cover, which requires you to show only that you cannot return to the specific job you held when MS prevented you from working. This type of cover is usually held through a private policy outside your super fund. |
If you are unsure which definition applies to your cover, your most recent super fund member statement or policy document will tell you.
If you have worked across several employers, you may hold an active TPD policy with each of your former super funds. Each policy is assessed separately, which can increase the total amount available to you.
Find out how much you can claim today
What do you need to prove for an MS TPD claim?
A TPD claim for MS needs to be supported by medical evidence showing that your condition prevents you from working on a long-term basis. Because MS affects each person differently, the evidence needs to address how your specific symptoms limit your capacity to work.
Most insurers expect you to provide:
- Reports from your treating neurologist confirming your diagnosis, the type of MS you have, and the progression of your condition
- MRI scans and other imaging that support your specialist’s findings
- Reports from your GP and any other treating doctors, such as a rehabilitation physician or occupational therapist
- A functional capacity assessment showing how your symptoms affect your ability to perform work tasks
- Your employment history, job description, and any return-to-work records or attempts to reduce your hours
- A written record of how your symptoms affect your day-to-day life, including fatigue, cognitive changes, mobility, vision, and heat sensitivity.
Expert tip
Keep a symptom diary for several weeks before lodging your claim. Combined with specialist reports that directly address fluctuating symptoms like fatigue and cognitive change, it gives your claim a stronger foundation than medical imaging alone.
How to claim TPD for Multiple Sclerosis
Claiming TPD for multiple sclerosis generally involves gathering specialist medical evidence and submitting your claim to your super fund or insurer for assessment. Because MS affects each person differently, the evidence you provide needs to clearly link your symptoms to your inability to work.
Step-by-step, here’s how the TPD claims process works:
- Contact your superannuation fund to confirm your TPD cover is active
- Request a copy of your policy document and review the definition of total and permanent disability
- Gather medical reports from your treating neurologist and any other specialists involved in your care
- Collect your employment history, job description, and any return-to-work records or reduced-hours arrangements
- Keep a written record of how your symptoms affect your day-to-day work, including fatigue, cognitive changes, mobility, vision, and heat sensitivity
- Complete your claim forms accurately and consistently with your medical evidence
- Submit your claim to your super fund or insurer with all supporting documentation
- Respond promptly to any requests for additional information during the assessment period
- Attend any independent medical examinations the insurer requires and request a copy of the report afterwards.
If you hold TPD cover across more than one super fund, each claim is lodged separately and assessed against the terms of that policy, and the claims can run at the same time rather than one after the other.
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Can a TPD lawyer help with an MS claim?
A TPD lawyer can help with an MS claim by reviewing your policy, gathering the right medical evidence, and dealing with the insurer on your behalf.
A TPD lawyer can help by:
- Reviewing your superannuation policy to confirm whether your MS meets the definition of total and permanent disability that applies to your cover
- Tracing TPD cover across current and former super funds, including accounts you may no longer use
- Working with your neurologist and treating doctors to make sure their reports address the specific symptoms insurers tend to query in MS claims
- Building a consistent record across your medical reports, employment history, and functional capacity assessments before your claim is submitted
- Managing communication with the insurer and responding to requests for further information or independent medical examinations
Challenging delays, disputed decisions, or unfavourable assessments throughout the claims process.
If you have been diagnosed with MS and are unsure whether you can claim, seeking legal advice early can help you understand the options available to you.
