Suffering a life-altering illness or injury is devastating, especially when it means you are unable to work. The impact can be more severe if you are the primary breadwinner in the household and have other dependents for whom you may be responsible. For many Australians, a Total and Permanent Disability claim is a crucial lifeline, offering a chance for financial security during a time of deep uncertainty.
Yet, navigating this complex and often frustrating process can feel overwhelming, especially when you are already facing emotional and physical hardship. Whether you need help clarifying eligibility requirements to make a submission, are waiting on a decision, or have already experienced a rejection, knowing how superannuation TPD claims work — and when to seek help — can make all the difference in avoiding common pitfalls.
Take the right steps towards a successful TPD claim — review our comprehensive TPD claim guide to understand your rights and discover how you could receive the maximum payout you are eligible for.
TPD refers to a condition, whether due to illness or injury, that prevents you from working in your usual occupation or any job suited to your education, training, or experience. A Total and Permanent Disability claim allows individuals in this situation to access a lump sum insurance benefits, often through their superannuation fund. This helps cover lost income, medical costs, rehabilitation expenses, and the broader financial strain caused by being unable to earn a living permanently.
While it offers a way to ensure financial stability, making a claim is still a huge event. These types of injury claims are not designed to support absences from work where you are expected to return to your role — it recognises that your condition renders you physically and/or mentally unable to work. It is also important to note that you can raise a superannuation TPD claim regardless of whether your injury and/or illness is related to your employment.
Understanding how TPD is defined in your specific policy is essential, as insurers and super funds each have their own definitions of what qualifies as TPD. Your claim will also be judged on your age and employment history, among other factors.
You can raise a claim for any medical condition — physical or psychological — that prevents you from returning to work in your usual role or any occupation suited to your training, education, or experience. These conditions must be supported by medical evidence and meet the definitions outlined in your superannuation or insurance policy.
Some conditions that qualify for a TPD payout include:
Mental Health Conditions | Neurological and Cognitive Disorders | Musculoskeletal and Orthopaedic Conditions |
|---|---|---|
Depression | Stroke with lasting impairment | Chronic back pain or spinal injuries |
Anxiety disorders | Traumatic brain injury | Severe arthritis or joint degeneration |
Bipolar disorder | Parkinson’s disease | Degenerative disc disease |
Post-Traumatic Stress Disorder (PTSD) | Multiple sclerosis (MS) | |
Schizophrenia | Early-onset dementia | |
Obsessive-Compulsive Disorder (OCD) |
Cancer and Terminal Illness | Cardiac and Respiratory Conditions | Sensory Loss and Mobility Impairment |
|---|---|---|
Advanced or aggressive cancer | Heart failure | Amputation of limbs |
Cancers with debilitating side effects from treatment | Chronic obstructive pulmonary disease (COPD) | Permanent paralysis |
Terminal illnesses with a prognosis of under 24 months | Autoimmune and Systemic Diseases | Blindness or significant vision loss |
Lupus | ||
Fibromyalgia (severe, medically supported) |
Eligibility for a TPD payout requires more than just a medical diagnosis — it involves meeting specific conditions defined in your insurance policy or super fund. Each superannuation TPD claim is assessed based on several key criteria, typically involving medical, occupational, and legal components such as:
Active policy:
You must hold a current policy through your superannuation or a retail insurance product.
Medical certification:
You must provide strong medical evidence — usually from two qualified specialists — confirming that your condition is permanent and prevents you from returning to work. While you may use medical practitioners who have previously treated you, your insurer may require you to visit a professional within their network.
Work capacity assessment:
Your insurer will consider your ability to return to any work. Depending on your policy, some insurers will investigate your capacity to work in your previous occupation or any role suited to your education, training, or experience. Some insurers may decline your
Total and Permanent Disability claim
if they believe you can work in a less-skilled role that can accommodate your condition.
Cessation of work:
You must have stopped working due to your condition and remained off work for a specified waiting period before your claim can be formally assessed.
Policy definitions and exclusions:
Your eligibility also depends on the wording of your superannuation policy, as some definitions are more restrictive than others. Depending on your contract, it could exclude certain conditions or limit coverage based on when the policy was taken out, your age and your employment history.
Before starting your claim, it is essential to understand who holds your TPD insurance policy to determine what you need to medically and legally prove to support your claim. Generally, a Total and Permanent Disability claim can be made through either:
Most Australians hold TPD insurance through super without even realising it. Super funds typically include default TPD coverage as part of their member benefits, and premiums are deducted automatically from your super balance. If you are making a super fund TPD claim, you are claiming against the group insurance policy held by your super fund.
What this means for you:
The super fund and its insurer jointly manage the claim process.
You must meet both the insurance policy’s definition of TPD and the superannuation fund’s internal requirements.
Accessing a TPD insurance payout may also require satisfying the conditions of release under superannuation law.
You can lodge claims with multiple super funds if you have multiple active policies.
If you’ve purchased TPD insurance outside of your super through an insurer or as part of a financial product, your claim is made directly with the private insurance company. These are known as individual or retail TPD policies.
What this means for you:
Definitions and terms are often stricter but sometimes more comprehensive.
Premiums are paid directly, not through your super.
The claim may not require the same superannuation release conditions but may have different financial and taxation implications.
Timeframes for managing TPD claims
Timing your TPD claim is crucial. While there are often no fixed statutory deadlines, both delays in lodging and lengthy processing periods can complicate your case and affect your outcome.
In most cases, there is no strict legal time limit for lodging a superannuation TPD claim. However, your super fund or insurer may impose internal deadlines, such as requiring that you stop working due to illness or injury within a certain period relative to when you held active TPD insurance coverage.
Failing to act promptly can lead to complications such as:
Loss of insurance coverage if your account becomes inactive
Difficulty obtaining medical records or employment history from years prior
Disputes around the actual date of disablement
Disputes about whether your condition is a result of an existing issue
Increased scrutiny from insurers, especially if there is a long delay between stopping work and lodging the claim
To avoid these risks and improve your chances of a successful TPD claim, it is best to seek legal advice from a specialised TPD lawyer before you initiate a claim.
It generally takes six to 12 months to assess and finalise a superannuation Total and Permanent Disability claim. The timeframe depends on several variables, including:
The complexity of your injury and/or medical condition
The quality of your supporting documents and how comprehensive they are
How responsive medical providers, employers and other stakeholders are throughout the process
How quickly your insurer or super fund processes your claim
Whether your claim is disputed or requires further investigation
Delays can occur, especially if the insurer requests additional medical assessments or legal clarification. You can help accelerate the process by:
Submitting all required forms and evidence promptly
Maintaining open communication with your super fund or TPD lawyer
Consulting one of the many experienced ‘TPD lawyers near me‘ at Brydens Lawyers who can ensure everything is prepared from the outset, including managing proceedings and communication between all parties and help gather evidence
A lump sum TPD payout can offer financial security, but it could also become a taxable event and even affect a Centrelink benefit. While it is necessary to maintain your lifestyle during a difficult time, you also need to consider how it will affect your future budgeting and life planning.
Successful TPD claims could entitle you to a payout of tens to hundreds of thousands of dollars, and even more in exceptional cases, depending on your policy and the number of active policies you have.
What influences your payout includes:
Your policy is active at the time of disablement
The level of cover held within your super fund or through a retail policy
Your age and employment status at the time of disablement
Whether you held multiple super accounts with overlapping TPD cover
The conditions and exclusions listed in your policy
The amount secured can vary from the stated amount of your policy, depending on your insurer and the super fund’s assessment. Hiring a dedicated TPD lawyer from Brydens Lawyers offers you the best opportunity to secure the maximum payment you are entitled to. Boasting an established reputation for successfully navigating TPD claims, personal injury and employment laws, you can rely on their expertise to smoothly manage the claims process and defend your rights.
How tax policies treat your TPD insurance payout depends on how the funds are accessed. If you are under 60, when you can more freely access your superannuation, tax may apply if the benefit is paid into your super and withdrawn. Funds secured through retail policies may be held outside your super and treated differently. It is important to consult a financial adviser who can help you navigate these rules and manage tax liabilities.
While TPD funds held in your super may be exempt from Centrelink’s assets test before retirement age, like any income streams you expect to receive, depending on your circumstances, they can potentially reduce or eliminate eligibility for certain payments once withdrawn. Reviewing your options with Centrelink or a financial expert is advisable to understand how to best manage your current and future finances.
Whether you are lodging a TPD claim through your super fund or a retail policy, follow these steps in our TPD claims guide to give your application the best chance of success.
Check if you have TPD insurance through super or a retail insurer by reviewing your statements or directly contacting them to confirm:
If your TPD cover is still active
The amount you are insured for
The definition of TPD under your policy
It is possible to make multiple claims if you have several policies, so be sure to check coverage for each contract you hold.
You must have ceased work due to illness or injury. Gather supporting documents from your GP and other specialists to prove that your condition is permanent and prevents you from returning to work in any suitable role.
Contact your super fund or insurer and request a TPD claim pack. This usually includes:
Member statement
Employer’s statement
Medical reports
Authorisation to release medical and employment records
Ensure all documents are complete, accurate, and signed where necessary.
Lodge the completed forms with the super fund or insurer. During these proceedings, your superannuation fund acts as the first decision-maker and will review all documentation before passing it to the insurer for formal assessment.
On the other hand, if you have purchased a retail policy through a private insurer, you will need to submit your documentation directly to them as the first and final decision maker.
Your insurer may request further independent medical examinations (IMEs) to verify the extent of your disability. This is a normal part of the process, especially for complex or mental health-related claims.
The review process can take up to 3 to 12 months, depending on the complexity of your case and how responsive other involved parties are. During this time, the insurer may:
Ask for further evidence
Contact your doctors or employer
Request interviews or statements
If your TPD insurance payout is approved, the lump sum is paid into your super fund or directly to you (depending on policy type). You will then need to meet superannuation release conditions to access the funds.
Engaging a specialist TPD lawyer can be key to navigating the appeals process and ensuring that all legal grounds have been adequately pursued. If your claim is denied, you have the right to dispute the decision through:
Internal review
AFCA (Australian Financial Complaints Authority)
Legal action with the help of
TPD lawyers
Despite meeting the definition of permanent incapacity, many people face the frustration of having their Total and Permanent Disability Claim denied. Avoiding the following common mistakes can strengthen your application for a successful claim.
Medical reports that are vague, inconsistent, or incomplete may fail to provide the full contextual information to directly address your inability to return to work.
Each insurance policy defines total and permanent disability differently, which may fall outside your interpretation. It is key to confirm their criteria, as misunderstanding these terms can lead to false expectations and premature claims. Some require that you be unable to work in any occupation, while others may accept the inability to return to your previous role.
Your previous employment will be reviewed to understand whether you can work or if it conflicts with your TPD application.
Even though there is no strict deadline, long gaps between ceasing work and lodging a claim can raise red flags for insurers. They may argue that your disability was not immediate or that you were not permanently incapacitated when you stopped working. It can also become harder to gather evidence, as doctors and other medical professionals may not be able to link your medical circumstances to the reason you are submitting a TPD insurance claim.
Missing forms, unsigned documents, or inconsistent information between your claim forms, employer statements, and medical reports can derail your application.
Filing a Total and Permanent Disability Claim involves more than just filling out forms and undergoing medical consultations — it is a legal process that demands strategy, precision, and a deep understanding of insurance law. Engaging experienced TPD lawyers can dramatically improve your chances of lodging a successful TPD claim, especially if facing complex definitions, unclear policy terms, or resistance from insurers.
TPD insurance policies often contain dense, legal language that can be difficult to interpret. A TPD lawyer can decode the fine print to clarify:
What Total and Permanent Disability means in your case
What exclusions or clauses may apply
Whether you qualify under the “any occupation” or “own occupation” test
Insurers often reject claims due to inadequate or conflicting medical documentation. A lawyer can help:
Identify the right specialists to support your claim
Ensure medical reports align with legal requirements
Coordinate the timing and consistency of assessments
Insurers may ask confusing or invasive questions, request further documentation, or delay the process. TPD lawyers can act as a buffer, handling all communication to ensure your rights are protected and you are not pressured into premature decisions or making false declarations.
If your claim is denied, a dedicated TPD lawyer can challenge the decision through:
Internal appeals with the super fund or insurer
Lodging complaints with the Australian Financial Complaints Authority (AFCA)
Pursuing court proceedings, if necessary
By identifying multiple super funds, coordinating additional claims, or exposing underpayments, a skilled Total and Permanent Disability lawyer can help you claim the maximum TPD insurance payout you are entitled to, not just what the insurer is willing to offer.
When your future depends on the outcome of a successful Total and Permanent Disability Claim, the legal team you choose matters. At Brydens Lawyers, we bring over 50 years of experience advocating for our clients across Australia, with a longstanding reputation for achieving results in even the most challenging cases.
From mental health cases and chronic illness to catastrophic injuries and terminal diagnoses, we take the time to understand the unique challenges of your claim and create a personalised plan to secure the maximum TPD insurance payout you are entitled to.
With legal offices throughout Sydney, regional NSW and Canberra, finding TPD lawyers near me is simple. From helping gather supporting material and preparing legal documents to negotiating with insurers and challenging rejections, you will not have to navigate paperwork, deadlines, or insurer tactics alone. We will take care of every stage of the process so you can focus on your recovery and getting the most out of your lifestyle.
At Brydens Lawyers, we strive to ensure that financial stress should not stop you from defending your rights. That is why we operate on a No-Win, No-Fee* basis. That means that if your claim is unsuccessful, you will not be charged legal fees (*Conditions apply). Do not delay submitting your TPD claim any longer. Book a consultation today to get the clarity and peace of mind you deserve.
We're here to assist you in claiming the compensation you deserve on a No Win, No Fee* basis. Enquire now to start your claim today. *Conditions apply.