Total Permanent Disability (TPD) Claim Eligibility and Requirements

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When you’ve been injured, lodging claims and paperwork only makes things worse. At Carbone Lawyers, we manage the whole process so you can just focus on your recovery.

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Our no win, no fee policy means that most personal injury claims have no upfront fees.

A life-changing injury or illness that prevents you from returning to your profession or any other work is overwhelming in and of itself. Adding the complexities of a Total Permanent Disability (TPD) claim can make this already stressful time even more challenging. 

Carbone Lawyers recognise the critical financial support these claims can provide to individuals and their families during such challenging times. With over 30 years of experience in Victoria, our empathetic legal experts are dedicated to guiding you through the TPD claim process, ensuring you understand your eligibility, what the requirements are for a TPD claim and the medical conditions that qualify.

What is Total and Permanent Disability (TPD)?

Total and Permanent Disability insurance is a provision within your superannuation or life insurance policies designed to offer financial relief if you are permanently unable to work due to injury or illness. The definition of TPD can vary significantly between policies, but it generally covers individuals who are unlikely ever to be able to engage in any regular remuneration work for which the injured person is reasonably suited having regard to their education, training or experience as a result of their injuries, illness or condition. 

Key Eligibility Criteria for TPD Claims

To be eligible for a TPD claim, you must satisfy specific criteria outlined in your insurance policy. These usually include:

  • Medical Conditions: Not all conditions are eligible for TPD claims. The severity and permanence of your condition, backed by comprehensive medical evidence, play a vital role in determining eligibility.
  • Employment Considerations: Your ability to return to work, considering your education, training, and previous experience, is critically assessed. TPD policies often require that you are not just unable to return to your previous job but any gainful employment.
  • Waiting Periods: Most policies impose a waiting period, typically between three and six months, during which you must be unable to work due to your disability.

What Medical Conditions Qualify for TPD Claims?

TPD claims cover a wide range of medical conditions, both physical and psychological. Qualifying conditions often include (but are not limited to):

  • Chronic illnesses such as cancer, MS, or heart disease.
  • Severe mental health issues, including depression and PTSD.
  • Significant physical injuries resulting in mobility issues or cognitive impairments.

The Process of Making a TPD Claim

Navigating the TPD claims process can be complex, but with Carbone Lawyers, you don’t have to do it alone. Here’s a simplified overview of the steps involved:

  1. Evaluation of Your Policy: We start by thoroughly reviewing your superannuation policy to understand the specific definitions and criteria of TPD it contains.
  2. Gathering Evidence: Collecting detailed medical reports and evidence is crucial. We work closely with medical professionals to ensure your condition is accurately documented.
  3. Claim Submission: Our team assists with a comprehensive claim submission, setting out the applicable definition and wording of your policy. We complete all  necessary forms and documentation, which are then lodged with your superannuation fund or insurer.
  4. Assessment: The insurer will assess your claim, which may involve additional information requests or independent medical examinations.
  5. Decision: Once your claim is fully reviewed, the insurer will make a decision. If approved, you will receive a lump-sum payment. If denied, you may have the option to appeal the decision.

Why Choose Carbone Lawyers?

Making a TPD claim is not straight forward, and is often fraught with challenges. Insurers may dispute the permanence of your disability, the adequacy of your medical evidence, or your inability to work in any capacity. The insurer will also assess whether you have upheld your duty of disclosure. This is where Carbone Lawyers can make a significant difference, leveraging our expertise to navigate these challenges and advocating on your behalf.

If you’re considering a TPD claim or seeking clarity on your eligibility and the requirements, Carbone Lawyers is here to support you every step of the way. Don’t navigate this journey alone. Contact us and let our experienced team provide the guidance and representation you need to secure your entitlements.

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