Here are a few case studies that may help to explain what a TPD claim is.
Please note that there are many variations of circumstances that make up a TPD claim, so contact us to discuss your unique situation.
Matthew sustained an injury to his lower back as a result of a work place incident. Following the incident, Matthew received payments from WorkCover. Matthew was medically cleared to perform suitable duties and returned to work performing an administrative role with his employer. Unfortunately Matthew’s employment was terminated soon after as he was unable to sustain these alternative duties. He was experiencing severe pain in his lower back from sitting for long periods of time in front of the computer.
Matthew’s doctors confirmed that his condition was unlikely to improve over time and he was unable to find a job that would be suitable in light of his injury related restrictions. When the payments from WorkCover stopped Matthew contacted Trilby Misso to discuss his options. We contacted each of Matthew’s superannuation funds to confirm what insurance entitlements he had under each policy. We then lodged a TPD claim with two of Matthew’s superannuation funds as well as a claim for Income Protection.
The Cabinet Maker
Lawrence is a 58 years old Cabinet Maker who sustained an injury to his right knee and hip and was no longer able to kneel, squat or stand for long periods of time. Lawrence’s doctors were of the opinion that he was unlikely to ever return to his previous occupation as a Cabinet Maker. His doctors suggested he should look at applying for a job in an office.
This greatly concerned Lawrence as he had only ever worked in his trade and had no office skills or experience. Lawrence contacted Trilby Misso to discuss his situation. We made enquiries with Lawrence’s superannuation fund to confirm the requirements for lodging a TPD claim. Under the superannuation fund’s policy document, TPD was defined to mean “unable to return to your previous occupation or any occupation for which you are reasonably fitted by training, education and experience.” We lodged a TPD claim on Lawrence’s behalf. Lawrence has advised us that if he is successful in his TPD claim he will use the money to undertake a TAFE course to develop his computer and office skills to allow him to return to the workforce.
The Self Employed Mechanic
Joe was involved in a motor vehicle accident and injured his right arm and leg. The arm was fractured in the accident and he was unable to move his arm for three months. Joe is right hand dominant. He contacted Trilby Misso to discuss his situation. Thankfully, Joe had an up to date superannuation policy with a TPD Benefit with an “any occupation” definition.
Medically, Joe’s claim is valid as a result of the severe medical trigger and permanent nature of the injury. The definition of “any occupation” needed to be looked at because although he can’t participate in the 20% manual work, he is still able to perform the 80% administrative and supervision duties. Unfortunately in Joe’s case, as he is still able to complete 80% of his duties, Joe’s claim would not meet the definition of “any occupation” TPD. However if Joe’s workload was 100% manual work and he was untrained or not qualified for any other occupation then he would have a valid TPD Claim.
Jenny is a Registered Nurse and has been working for Queensland Health for several years. At 47 years of age, Jenny was diagnosed with breast cancer and although her prognosis was good she decided to take early retirement to focus on her health. When Jenny made this decision she spoke to Trilby Misso about her situation and they determined she was covered under a Government Superannuation Scheme for Invalidity Cover (also known as TPD).
Under the government scheme, Trilby Misso can assist Jenny make a claim for invalidity retirement benefits (TPD). The trustee of the Government Superannuation Scheme will make a decision as to whether or not they accept Jenny’s claim on the basis of medical evidence presented.
The Transport Worker
Katharine had been employed in the transport industry for approximately 15 years when she was forced to stop working after she was diagnosed with fibromyalgia and chronic fatigue syndrome. Some 11 years after she ceased working, Katharine contacted Trilby Misso who made her aware that she was still able to make a claim for TPD under her superannuation fund.
Katharine’s claim was initially rejected by her superannuation fund but after some perseverance and support from her legal team the claim was finally accepted. Katharine received a lump sum amount to enable her to secure
her financial future.
The sales representative
Deon, a 23 year old man, worked for a national retailer as a sales representative. He is married with two young children and has many household expenses. Deon’s doctor diagnosed him as having Multiple Sclerosis (MS) when he began feeling extremely tired. Soon after this diagnosis he resigned from his position at the retailer as he was unable to handle the physical workload required in his role. Deon was never made aware that he could make a TPD claim until he heard somebody talking about superannuation and the insurance attached to it. Deon decided to seek Trilby Misso’s advice and look into whether or not he could make a claim. Thankfully, Deon had TPD cover attached to his superannuation and was able to make a claim. The trustee for the superannuation fund accepted his claim and made a lump sum payment that has made life easier for him and his family.