FAQs

Navigating TPD claims is daunting and confusing! I get A LOT of questions!

Here are some answers to some Frequently Asked Questions I receive.

FAQs

TPD Claim FAQs

Navigating a TPD (Total and Permanent Disability) claim can feel confusing and overwhelming — especially when you’re already coping with health challenges. This page answers the most common questions about TPD claims in Australia, including how to qualify, how the process works, and what to expect.

As a dedicated TPD claims advocate, I’m here to make the process simpler, clearer, and less stressful — guiding you from start to finish, with compassion and care, so you can access the financial support you deserve.

A TPD (Total and Permanent Disability) claim provides a lump-sum payment if illness or injury prevents you from ever returning to work. Most Australians have TPD insurance automatically included in their superannuation fund.

You may be eligible to claim if your condition means you are unlikely to work again in your usual occupation or in any occupation suited to your education, training, and experience. The payment can help relieve financial pressure by covering living costs, medical expenses, or debts.

How I Can Help: I can review your superannuation accounts and insurance policies to confirm whether you hold TPD cover and explain what benefits you may be entitled to.

You may be eligible if:

  • You can no longer perform the duties of your usual occupation or any occupation you are qualified for.
  • Your condition is considered permanent by your treating specialist.
  • You were insured under a TPD policy when you stopped working due to illness or injury.
    Each insurer uses its own definition of “total and permanent disability”, so eligibility can vary.

How I Can Help: I’ll review your policy wording and medical history to determine if you meet your insurer’s definition of total and permanent disability and help prepare strong supporting evidence.

TPD policies generally fall under one of two definitions:

  • Own Occupation: You’re considered totally and permanently disabled if you can no longer work in your usual occupation — the specific job you were doing when you became unwell or injured.
  • Any Occupation: You’re considered totally and permanently disabled only if you’re unable to work in any occupation for which you are reasonably suited by education, training, or experience.

The “own occupation” definition is usually easier to satisfy, as it focuses on your ability to return to your previous job. The “any occupation” definition is stricter and is the most common type of TPD cover within superannuation funds.

How I Can Help: I can review your insurance policy to confirm which TPD definition applies to you and assess how your medical and employment evidence supports your claim under that definition. This ensures your claim is presented clearly and strategically from the start.

In TPD claims, the terms education, training, and experience are used to determine whether you can work in an occupation other than your usual job. This is particularly important under the “any occupation” definition of TPD.

  • Education: Formal qualifications or certifications you have earned.
  • Training: On-the-job or professional training that equips you with specific skills.
  • Experience: Practical work experience gained from previous jobs or roles.

Insurers assess whether you are capable of performing any role that reasonably matches your education, training, and experience. If you cannot, this strengthens your TPD claim.

How I Can Help: I review your work history, qualifications, and training to clearly demonstrate to the insurer why you are unable to work in any suitable occupation, ensuring your claim is presented accurately and convincingly.

A Most TPD claims take between 3 and 12 months, depending on the insurer’s requirements and the complexity of your medical evidence. Understanding the requirements and providing targeted, relevant evidence is key to a smoother and quicker approval.

Delays often occur if forms are incomplete or if additional medical reports are requested. Timing is also important — submitting a claim too early, before you’ve reached maximum recovery or participated in reasonable treatment and rehabilitation, can slow the assessment process.

How I Can Help: I help avoid unnecessary delays by ensuring all information and documentation is provided upfront. I manage your claim end-to-end—submitting forms correctly, responding promptly to insurer requests, and following up regularly—so your claim moves through the process as efficiently as possible.

Typical evidence includes:

  • Medical reports from your treating specialists.
  • Job descriptions or occupational assessments.
  • Statements outlining your daily limitations.
  • Relevant medical history or prior claims information.

How I can help: I work with you and your doctors to gather the right evidence, and present it in a way that aligns with the insurer’s requirements.

Yes, you can lodge a TPD claim yourself, but the process can be complex and time-consuming. Having a dedicated advocate significantly increases your chances of success.

TPD claims require:

  • Completing detailed forms accurately
  • Providing comprehensive medical evidence from multiple treating practitioners
  • Understanding your policy definitions (own occupation vs any occupation)
  • Ensuring all deadlines are met and additional requests from insurers are addressed

Mistakes or incomplete submissions are a common reason claims are delayed or denied. While self-lodging is possible, engaging a specialist TPD claims advocate is often a valuable investment. Advocates know how to navigate the system efficiently, gather the right evidence, and present your case clearly to maximise your chances of approval.

How I Can Help: I manage the entire claim process on your behalf, from reviewing your insurance policy and collecting medical evidence to lodging your claim and communicating with the insurer. This professional guidance significantly improves your likelihood of a successful outcome and reduces stress for you, so you can focus on your health and recovery.

You may be able to:

  • Request a review or appeal with your insurer.
  • Seek independent advocacy to challenge the decision.

How I can help: If your claim has been declined, I review the insurer’s reasoning, identify gaps in evidence, and prepare a strong case for review.by handling the paperwork and correspondence, so you can focus on your health and recovery.

Your payout amount depends on the level of cover within your super fund or insurance policy at the time you stopped work.

Some policies provide a fixed lump sum, while others are based on your age and account balance.

How I Can Help: I can check your current policy and superannuation details to estimate your likely payout amount.

Yes — if you held multiple superannuation funds or separate insurance policies at the time you became disabled, you may be able to claim on each one.

Each policy is assessed independently, and successful claims can be paid from more than one fund.

How I Can Help: I’ll identify all possible funds and policies where you may be covered and coordinate multiple TPD claims on your behalf.

Yes. Mental health conditions such as depression, anxiety, bipolar disorder, or post-traumatic stress disorder (PTSD) are among the most common reasons for TPD claims in Australia.

The key factor is whether your condition prevents you from returning to work permanently. Insurers require detailed medical evidence from treating psychologists, psychiatrists, or other health professionals to support the claim.

How I Can Help: Mental health claims are often complex and require a specific approach. I work with you to protect you from the stress of the claims process and ensure your medical evidence clearly demonstrates your condition, easing the impact on your mental health while your claim is managed from start to finish.

Yes. TPD benefits paid from superannuation are not automatically tax-free. Tax is generally payable when the benefit is withdrawn, and the rate depends on factors such as your age and the tax components of your super.

We recommend seeking financial advice before accessing your benefit to understand your tax obligations.

How I can help: I connect you with trusted financial advisers so you fully understand the tax side before making decisions.

A Claims Advocate can provide expert support throughout the claims process, including:

  • Reviewing your policy and eligibility – Understanding what cover you have and whether you qualify.
  • Preparing and presenting your claim correctly – Ensuring forms, medical evidence, and supporting documents are complete and accurately presented.
  • Communicating with insurers on your behalf – Acting as your liaison to reduce stress and ensure timely responses.
  • Improving your chance of a successful outcome – Using experience to position your claim clearly and persuasively.

How I Can Help: I act as your voice throughout the entire claims process, managing paperwork, liaising with insurers, and making sure your claim is not only submitted but strategically positioned for the best possible result.

Starting a TPD claim through your super fund usually involves the following steps:

  1. Confirm your cover – Check that you hold TPD insurance through your super fund.
  2. Obtain claim forms – Get the necessary forms from your fund or insurer.
  3. Complete personal and medical statements – Fill out your statement and have your treating doctor complete the medical statement.
  4. Provide supporting evidence – Supply relevant medical reports, employment history, and financial information.
  5. Submission and assessment – Once submitted, the super fund and insurer review your claim to determine if you meet their policy definition of total and permanent disability.

How I Can Help: From your very first call, I outline every step of the process, gather the right documents, and lodge your claim on your behalf. I manage the entire process—from forms and medical evidence to submission—ensuring everything is accurate, complete, and submitted on time, reducing stress and improving your chances of a successful outcome.

No – A TPD Claims Specialist or Advocate is often the better option.

We focus on presenting claims correctly, not litigation. A specialist can:

  • Translate medical and work evidence into policy terms.
  • Avoid unnecessary legal costs.
  • Work directly with insurers to achieve results.
  • Communicate with you in a language that you can understand.

How I can help: I focus 100% on getting your claim approved, without the added legal fees or complications.  My goal is to achieve the best possible outcome for you quickly and with care.

The best time to seek advice is before submitting your claim. Early guidance ensures your claim is set up correctly from the start, reducing the risk of delays or rejection.

Getting advice early helps you:

  • Avoid potential red flags or mistakes in your claim
  • Ensure your claim is prepared and presented clearly
  • Make sure all supporting evidence is complete and accurate

How I Can Help: I can review your situation before you lodge your claim, identify any potential issues, and help you prepare a strong, well-documented submission to maximise your chances of approval.

I believe in being transparent and fair.

The minimum fee for a TPD claim usually starts at $15,000 (plus GST). The exact fee depends on the complexity of your claim and the level of work required.

I work on a success-based fee – which means you only pay if your claim is approved.

I also:

  • Offer fixed or capped fees so there are no surprises.
  • Provide a clear, documented process so you know exactly what you’re paying for.

How I can help: I make sure you have complete transparency on costs from day one, so you can focus on your claim with confidence.