What should I know about Mental Health Evidence for TPD Claims?
Start with the insurance policy attached to the relevant super account. TPD generally concerns a policy-defined level of permanent work incapacity, but definitions, cover dates and evidence requirements differ. A diagnosis or inability to do one job does not automatically establish approval.
What TPD through super generally means
Mental health TPD evidence should describe treatment continuity and the practical effects on attendance, concentration, judgment, interaction, stress tolerance and daily function. It should also explain variation over time without treating one appointment as the whole picture. TPD is an insurance benefit that may be attached to superannuation. It is not a general payment for having a serious diagnosis or injury. The insurer and trustee assess the claim under the definition, exclusions, cover and procedural requirements that applied to the relevant account and date.
Check the policy definition before drawing conclusions
Policy wording can differ between funds, products and periods of cover. Some definitions focus on work suited by education, training or experience; others may use different tests depending on employment status or other policy conditions. The actual documents should be obtained rather than relying on a summary webpage.
- Identify every potentially relevant super account and insurer
- Confirm cover, premiums and the date the applicable definition is assessed
- Read the full TPD definition, exclusions and claim requirements
- Check how occupation, education, training, experience and employment status are treated
Evidence checklist for this TPD issue
Collect records in their original form and organise them by date. Strong evidence is relevant, consistent and connected to the policy question; a large unsorted bundle may hide rather than resolve an important gap.
- Complete GP, hospital, allied-health and diagnostic records, not selected extracts only
- GP reports explaining diagnoses, treatment, restrictions, function and expected course
- Relevant specialist reports addressing diagnosis, treatment response, prognosis and capacity
- A dated treatment, medication, rehabilitation and referral history, including response and side effects
- Specific examples of limits in concentration, attendance, movement, stamina, self-care and daily tasks
- Capacity certificates, occupational assessments and consistent restrictions recorded over time
- Records of reduced hours, modified duties, failed work attempts, absences and why an arrangement ended
- A dated chronology of symptoms, treatment, work changes, fund communications and claim decisions
Connect medical evidence with work history and function
Medical reports should explain findings, treatment, prognosis and practical restrictions within the clinician’s expertise. Work material should explain real duties, hours, reliability, accommodations and failed attempts. Together they should show what can or cannot be sustained, not just list diagnoses and job titles.
Common fund and insurer issues
Identify the precise issue before adding more material. A claim may involve several distinct questions at once, and each should be answered with the policy and evidence relevant to it.
- Records are selected around a conclusion rather than collected completely
- Reports repeat diagnoses but do not explain practical capacity
- The work chronology conflicts with medical or income records
- Important policy, cover or account documents are missing
Common mistakes to avoid
Keep the claim accurate and evidence-led. Do not stop necessary treatment or ask a clinician to make legal findings outside their role.
- Assuming a condition, surgery or long absence automatically qualifies
- Using a generic TPD definition instead of the policy that applied
- Leaving gaps in super membership, treatment or work history
- Describing only the worst day rather than the sustainable pattern over time
- Ignoring a fund or insurer request, deadline, rejection reason or inconsistency
Practical next steps
List all super accounts, obtain the policy and cover history, create medical and work chronologies, preserve insurer correspondence and identify unanswered questions. Early review can help determine which evidence is relevant without promising that the claim will be approved.
Send your TPD claim detailsDocuments and records
TPD records to gather before an enquiry
A TPD enquiry usually needs both medical evidence and work-history material, not just a diagnosis.
- Date, location and short description of the injury event
- Medical certificates, reports, scans, treatment records or hospital documents
- Employer, insurer, police, incident or venue records where relevant
- Photos, witness details, dashcam or other supporting material if available
- Income, superannuation, work capacity or leave records where relevant
- Letters, emails, claim numbers and decisions already received
Common questions
TPD claim questions
Short general answers only. The right next step depends on the facts, dates and documents.
Does this condition or situation automatically qualify for TPD?
No. A diagnosis, injury, inability to perform one role, rejection or delay does not by itself establish entitlement. The applicable policy definition, cover and evidence must be assessed.
Can TPD definitions differ between super funds?
Yes. Definitions and conditions can differ between funds, insurance products and periods of cover. Obtain the policy that applied to the relevant account and date.
What evidence is commonly needed for a TPD claim?
Common material includes the policy and cover history, complete medical records and reports, treatment and function evidence, a detailed work history, job duties and records of work attempts or changes.
Can limited work or a different job affect a TPD claim?
It can. The significance depends on the policy wording and facts such as duties, hours, support, reliability, earnings and whether the work is genuinely sustainable.