- July 18, 2023
- Posted by: Seymour Furlong
- Category: Superannuation/ TPD Claims
Total and Permanent Disability (TPD) coverage provides security for people who can no longer work due to serious illness or injury, including workplace accidents. However, not all injuries are physical.
Work can also profoundly impact your mental health, causing mental disorders such as depression, severe anxiety, and post-traumatic stress disorder. Some people also become unable to work after developing mental disorders for unknown reasons.
Making a TPD claim is possible in such cases — but proving the merit of your claim is difficult. With a skilled personal injury lawyer in your corner, your odds of receiving the support you need rise dramatically.
Understanding TPD Claims
Total and Permanent Disability (TPD) is defined as an extensive disability that permanently renders someone unable to work, in their own profession or any other for which they are reasonably qualified.
Queenslanders may have TPD coverage through their superannuation funds or private life insurers, providing them with a lump sum payment to support their care and financial security.
Eligibility Criteria for Making a TPD Claim
You may make a TPD claim if you have TPD coverage and can prove that you are permanently unable to work due to injury or illness, which includes mental health conditions.
Determining Eligibility for TPD Coverage
Many mental disorders, including most forms of depression, are considered temporary and treatable. TPD eligibility may arise if you have exhausted all first-line treatment options, have tried treatment options of last resort, and are actively under the care of a relevant physician.
TPD payments may be available to people not expected to recover to the point where they can return to work.
TPD Claims for Depression: What Do You Need to Know?
People who suffer from depression, anxiety, PTSD, and other mental disorders may qualify for a TPD payment. Successful claims depend on the ability to prove that the condition does not only prevent you from working now, but is likely to be permanent.
Is Depression a Potential Qualifying Condition?
Depressive disorders like Major Depressive Disorder, Persistent Depressive Disorder, Postpartum Depression, Premenstrual Dysphoric Disorder, Bipolar Disorder, and Major Depressive Disorder secondary to another medical condition, including a work-related accident, may qualify for TPD claims.
Treatment-resistant forms of depression, and those co-occurring with a serious physical disability, are most likely to result in successful TPD claims.
How Depression Impacts Functioning and Employability
The symptoms of depression include demotivation, feelings of worthlessness, overwhelming sadness, irritability, and physical sluggishness.
These symptoms can undeniably temporarily impact someone’s ability to work, including in:
- Customer service roles
- Jobs requiring the operation of heavy machinery
- Positions requiring clear thinking and fast reaction speeds, including law enforcement and first responders
In addition, the workplace environment can sometimes exacerbate the symptoms, such as in professions requiring shift work or those where people are confronted by death and suffering (such as the medical field).
A successful TPD claim does not require claimants to prove that their depression was caused by their jobs. However, claimants do have to show that their diagnosed depression, rather than another factor, renders them unable to carry out their duties.
Gathering Evidence for a TPD Claim
Extensive documentation strengthens every TPD claim. Let’s look at the evidence claimants need to gather to make a claim.
Medical Documentation and Diagnosis of Depression
Obtaining a formal diagnosis from a qualified mental health professional and collecting statements from at least two physicians are essential steps in building a strong TPD claim for depression.
Claimants will be asked to authorise their healthcare providers to release their medical records as part of the claim process, and these documents should show that all reasonable treatment options have been exhausted and proven unsuccessful.
Obtaining Expert Opinions and Assessments
TPD claimants must submit statements from at least two physicians but may submit further reports. These expert opinions should state that available treatments were unsuccessful, and further treatment options are unlikely to provide relief from depression and allow a return to work.
In collecting evidence of the impact depression has on your ability to work, workplace documents such as performance reviews and complaints can also play a role in proving that you are no longer fit for duty.
The TPD Claims Process
Understanding the TPD process before making a claim is critical. What do you need to know?
The TPD claims process is designed to be easy to follow and consists of the following steps:
- Complete the sections of the claim claimants are required to answer (Part A when claiming through QSuper), provide relevant supporting documentation, and authorise the release of your medical records.
- Ask your (former) employer to their the claim, providing all relevant information about work status and abilities.
- Ask your healthcare providers to submit a Doctor’s Statement.
Understanding the Role of Insurance Providers and Claim Assessors
Insurance companies and their assessors carefully assess TPD claims by reviewing the claim form, supporting documentation, and medical records. Claimants should always understand the eligibility requirements outlined in their policy or Super.
In complex cases, insurers may ask independent parties to review the claim.
Common Challenges and Pitfalls to Watch Out for During the Claims Process
Common reasons for TPD claims on the grounds of mental illness, including depression, to be rejected include:
- Incorrectly completed forms.
- Insufficient supporting documentation — you need to prove that you are not only unfit for work now but will remain so in the future.
- A lack of legal guidance.
Consulting a qualified personal injury lawyer is the best way to ensure your claim is submitted correctly.
Seeking Professional Assistance
Your future depends on the outcome of your TPD claim. Don’t go into the process unprepared. Get in touch with a skilled, experienced, and competent personal injury lawyer to guide you through your claim.
The personal injury lawyers at Seymour Furlong are available to discuss your claim and provide free legal advice when you are ready to start the process. We operate on a no-win, no-fee basis — so you won’t have to pay us unless we can help you get the support you need.
Our lawyers successfully assist clients with TPD claims all the time. Nothing can replace in-depth knowledge and experience. There is too much riding on your TPD claim to do it alone.