Total Permanent Disability (TPD) Claims are commonly made when people have been physically injured. You may not be aware that TPD claims can also be made as a result of mental injuries.
The Criteria to be Satisfied
When insurers evaluate TPD claims, they consider not only WHAT the injury is, but rather HOW the injury or disease has affected your capacity to work. It may be that a number of injuries and conditions have impacted your capacity to work. For instance, a person may sustain a physical work injury, then later a mental injury as a result of a different incident. In this example, if the effect of both the physical and mental injury renders them unfit for work – then this may all be taken into account in assessing a TPD claim.
The definition of “TPD” can differ significantly across various insurance policies and trust deeds. We recommend having a TPD lawyer review your insurance policies and trust deeds to determine your eligibility, the pre-conditions required to be met, and advise you on your claim.
So what about Mental Illness?
Over the last few decades, there has been a positive shift and perceptions have changed on issues surrounding mental health. You may be able to claim a TPD if a mental health condition stops you from returning to work within the definitions of your policy.
There are a number of mental health conditions that could prevent you from working. Depression, Post Traumatic Stress Disorder (PTSD) and Generalised Anxiety Disorder, to name a few. TPD policies generally won’t list the potential mental health conditions – though they may list particular exclusions. The key consideration is whether your condition has caused an incapacity to work within the meaning of the policy.
Making a TPD claim for Mental health
If someone has sought legal advice and it’s been determined that they are eligible under a policy to make a claim then it’s time to complete a claim form. A TPD lawyer can assist you through the claims process and ensure that your claim contains all the necessary parts required to optimise your likelihood of success.
As part of your claim, you will be required to submit medical evidence to support your claim. This process can be a complicated, multi-stage process. Your TPD lawyer will be able to guide you and assist in collecting all relevant evidence required, on your behalf.
TPD Lawyers are experienced in instructing Doctors (including Psychiatrists) and Psychologists. They know exactly the kind of information being requested to best support your claim. When an expert is asked to complete a medical certificate for a claim, or provide a medical report, they should be provided with the relevant definition of TPD and asked to comment in relation to it, so far as their expertise allows. This complicated process is made a lot smoother and more efficient with the help of a TPD lawyer. Remember, many factors can be taken into account when determining whether you meet the TPD definition- not only the primary injury or illness. Medical evidence on any mental health issues should be included, and an experienced TPD lawyer can help you ensure that all relevant information is collected and provided to support your claim.
Once your claim form has been submitted, and the insurer has all requested information, your claim will be assessed and a determination provided. Your TPD lawyer will be able to interpret the determination and advise on the best way to proceed. It may be that further evidence is required and then your claim be redetermined. It may be that you disagree with the insurer’s determination and wish to submit your claim for determination by a Court. A TPD lawyer will be able to help you evaluate the situation, consider precedent cases, and advise you on your options.
Schofield King Lawyers, the expert TPD lawyers, are proud advocates for mental health. We understand that the TPD claims process can be overwhelming, confusing and complicated, and are ready to advise you on your claim, no matter what stage you’re at- whether it’s to make a claim, collect medical evidence or challenge a denied claim. Call us and get your mental health TPD claim in motion today.