Physical and psychological conditions
Physical and psychological conditions can potentially support a TPD claim. The important question is whether your circumstances meet the applicable policy definition and other requirements. Psychological conditions including depression and PTSD are among conditions that can form the basis of claims.
A diagnosis alone does not establish eligibility. Medical evidence should address the effect of your condition on your ability to work and the requirements of the applicable definition.
If several conditions affect you, provide your treating practitioners with an accurate picture of your circumstances. The policy still determines the disability definition, exclusions and other conditions applying to the claim.
Checking past and current insurance
Check your current and previous superannuation funds, together with any insurance held outside super. TPD insurance can exist inside or outside superannuation.
Ask for your insurance history rather than relying only on your current statement. Cover can be affected by matters including a change of employment or an inactive super account, and the applicable policy may contain waiting periods and other eligibility requirements.
If your employment circumstances changed, keep a clear record of when that occurred. Some policies can apply different definitions depending on a person’s employment status.
Keep separate entitlements clear
South Australian workers compensation and TPD insurance are different arrangements. ReturnToWorkSA administers South Australia’s work injury insurance scheme, including claims following workplace injury. A TPD insurance claim is instead assessed against the definition in the relevant insurance policy.
Keep relevant medical retirement, employment and workers compensation records, but do not assume an outcome under another system determines your TPD claim.
For TPD cover held through superannuation, also check how the benefit can be accessed and how a withdrawal may be taxed. ASIC’s Moneysmart specifically recommends checking the access rules and tax treatment with your super fund.
Get help reviewing the cover
Book a free consultation with KSC Law about TPD claims in South Australia. Bring your current and previous super statements, insurance information and any existing claim correspondence. If you do not have everything, start with what you have.
KSC Law can help identify the applicable cover, explain the evidence that may be required and discuss the proposed costs arrangement before you decide whether to proceed.
Related reading: TPD claims lawyers · Do I qualify for a TPD claim
TPD guides and next steps
KSC supports TPD clients by phone and online.