Condition and TPD pathway
An injury may lead to a TPD enquiry when lasting restrictions affect work capacity, but the cause, diagnosis and severity do not decide the claim by themselves. The policy wording and reliable evidence of function and work history remain central.
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.
An injury may lead to a TPD enquiry when lasting restrictions affect work capacity, but the cause, diagnosis and severity do not decide the claim by themselves. The policy wording and reliable evidence of function and work history remain central. 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.
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.
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.
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.
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.
Keep the claim accurate and evidence-led. Do not stop necessary treatment or ask a clinician to make legal findings outside their role.
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 detailsClaim pathway
This is a general pathway only. The documents, decision-maker and timing can change depending on the facts and claim type.
Start with where and how the injury happened: road accident, workplace incident, public or private place, or a longer-term disability situation.
Get appropriate treatment and keep certificates, referrals, scans, reports and notes about how symptoms affect work or daily life.
Organise incident records, photos, witness details, wage records, claim numbers and correspondence in date order.
The pathway may involve a CTP insurer, workers compensation insurer, public liability insurer or superannuation trustee/insurer.
The insurer or fund may request material, assess treatment or work capacity, make a decision, or issue reasons that need a careful response.
The practical outcome may be approval, payment, treatment support, further evidence, review, dispute steps or another decision point.
Documents and records
A TPD enquiry usually needs both medical evidence and work-history material, not just a diagnosis.
Common questions
Short general answers only. The right next step depends on the facts, dates and documents.
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.
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.
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.
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.
TPD enquiry
Send the super fund details, work history, medical position and any insurer or trustee letter. TPD enquiries usually start with policy wording and evidence.
