Start with the right definition
Your policy may use an “any occupation” definition, which considers whether you are unable ever to work again in a job suited to your education, training or experience. Other policies may use an “own occupation” or activities of daily living definition.
Being unable to return to your previous job can therefore be important without necessarily establishing every policy requirement.
Find the policy wording and insurance history for the relevant period. If you have changed jobs, check whether that affected your TPD cover. If your insurance was held through super, also check whether inactivity affected the cover.
Explain attempts to stay at work
If you reduced your hours, changed duties or attempted to return to work, keep records of what occurred and why. This information can help explain your employment history when the insurer assesses the policy requirements.
Medical evidence should address your condition and the effect on your capacity for the work relevant to the policy definition. Physical and psychological conditions can potentially support TPD claims, subject to the applicable cover and exclusions.
If there is another claim underway
Victorian workers compensation and TPD insurance are different arrangements. WorkSafe Victoria describes WorkCover compensation for work-related injuries and illnesses, including weekly payments, treatment expenses and permanent impairment benefits. A TPD claim, by contrast, is assessed against the definition in the applicable insurance policy.
Keep relevant records from both matters, but do not assume an outcome under WorkCover establishes the outcome of a TPD insurance claim.
For TPD cover held through superannuation, also check the rules governing access to the benefit and taxation before making decisions about withdrawing the money.
Discuss your next step
Bring your current and previous super statements, insurance documents, medical reports already available and any claim decisions to a free consultation. If you do not have everything, start with the documents available.
KSC Law can identify the cover that needs to be checked, explain the applicable requirements and help assess the next steps for TPD claims in Victoria.
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.