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What do the definitions on my TPD Policy mean?

What is TPD and what can I claim?

The definition of Total and Permanent Disability (TPD) differs from claim to claim. However, the term “totally and permanent disability” will usually mean that you have sustained an injury or illness that prevents you from working in your usually occupation.

If you are TPD you may be eligible to claim compensation (money) under your TPD policy.

TPD policies are usually an entitlement under your superannuation policy, however, you may have a separate TPD policy, or your employer may be making contributions into a company TPD insurance policy.

TPD policies and insurance policies generally are complex and difficult to understand. To make things more complicated, each insurance policy has a different set of terms and definitions. What may be the TPD definition under one policy may be entirely different on another policy.

Why is this important to understand the terms of a TPD policy?

It is important to know what the terms in your TPD policy mean as they determine whether you are eligible for TPD compensation.

We have created a list of the most commonly used terms found in TPD policies to make it easier for you to understand your rights and entitlements.

Understanding TPD Terms and Definitions

Unlikely Ever:

Example: “An insured person is Totally and Permanently Disabled if, in our opinion, the illness or injury means that the Insured Person is unlikely to ever work in or attend their usual professional occupation…”

The best way to understand this definition is to look at your capacity to return to work. If there is a chance that you will return to work, even if that chance is less than 50/50 you will not be able to claim TPD benefits.

To be unlikely ever sets a very high threshold. It means that there is almost certain that you will never return to gainful employment as a result of your illness or injury.

To combat this definition, you need to look at the real likelihood of re-entering employment in the future and also address the prospects of being able to undertake the actual employment.

For example, if you may be able to return to work in the future but will require periods of time of work to recover when your symptoms are aggravated you would probably still satisfy unlikely ever and be able to claim your TPD benefit.

Unable Ever:

Example:“Total Disability and Totally Disabled means that as a direct result of suffering an illness or injury an Insured person is unable to ever perform at least one income-producing duty of their regular occupation…”

You are incapable of returning to employment. To combat a term like this it is best to have you’re treating practitioner or an expert report that you are “incapable to ever return to gainful employment”

“Unable ever” does not mean the employment in its entirety so when challenging a decision based on this term, you will need to establish that you cannot undertake certain aspects of the employment.

Retraining:

Example:“In determining our opinion on Total Permanent Disability we will have regard to factors including but not limited to; any retraining or re-skilling that could reasonably be expected to be undertaken by the Insured Member.”

Most TPD definitions have a term that states if you are able to be retrained in any form of employment you will not satisfy the definition for TPD and be eligible for benefits. The Courts have determined that retraining must be reasonable.

If the TPD insurer finds that you can be retrained you may be able to challenge this decision by proving that you are not suited for the training proposed and even if retrained would be precluded from employment due to the nature and extent of your injury or illness.

To challenge the insurers decision based on reasonableness you will need to consider the cost of retraining, the time it will take to be adequately trained, your age and the benefit of retraining, and the connection between previous employment and proposed employment. It may also be necessary to get an opinion from an occupational therapist.

It is important to keep in mind that a short course or training to obtain a licence or labouring ticket is not unreasonable, so long as once obtained you are fit and able to undertake the work.

As can be seen from these definitions, TPD claims are complex. In order to make the claims process smoother and less stressful we advise seeking the assistance of a lawyer to help you complete your claim form, obtain the right medical evidence the first time, and if necessary, request a review decision or take your claim to Court.

Garling & Co Lawyers

Matthew Garling

Matthew Garling is an Accredited Specialist in Personal Injury Law approved by New South Wales Law Society. He is admitted to practice in the Supreme Court of NSW and the High Court of Australia. Matthew is also a member of...
Ray H.
07:33 13 Jun 24
Matthew Garling and Team are kind, patient, polite, professional, empathetic and efficient. I was treated terribly by the at fault insurer. Garling and Co. had my back. Matthew gently and patiently... kept me up to speed on all the steps to go through. From my personal experience I recommend these guys. They are safe hands. Thank you team.read more
Jo L.
05:58 07 May 24
So very impressed with the professional team who looked after me throughout the last 4 and 1/2 years. A special mention to Kerry and Nathan who navigated each request to fight for my right to gain... access to further treatments and physio and to ensure medical treatment would be covered moving forward. I was so grateful I could hand it all over to you and not have to go through this very challenging time without your support.I thank you for the compassion you have provided to me, from the first contact with Matthew and Natasha, to finalisation with Kerry and Nathan.I highly recommend the team at Garling and Co for any third party compensation claims. You are in good hands with them all.read more
Linda O.
21:53 06 May 24
Emma, Rebecca and the team at Garling and Co have worked diligently throughout my workers compensation claim. The level of professionalism, support and communication has been faultless. Of particular... note has been the sensitivity displayed to me throughout the lengthy process. Worker’s compensation claims are complex and not easy to navigate, particularly when you are unwell. I do not hesitate to recommend Garling and Co to help you find a way through this otherwise unfathomable system.read more
Keith H.
20:51 23 Apr 24
After my case stalled with another firm, I decided to give Matthew Garling a call. He took my case and not only won, but achieved an outcome that far exceeded my expectations. This firm is the best... in the business in my opinion and I wouldn't hesitate to recommend them to anyone.read more
Anthony T.
00:50 16 Apr 24
Thank you Matthew and his team who guided me through the legal process, a truly positive experience with total professionalism.
Mikaele N.
03:01 15 Apr 24
Garling &Co Lawyers were awesome, I called every compensation law firm and was told that I couldn't claim for compensation.The whole experience and process was simple and stress free.Mr Matthew... Garling and Allison deserve an accolades for the very best in client service. I would highly recommend their service to anyone.read more
Tamara L.
02:10 15 Apr 24
I want to thank Garling & Co so much for all the help they have given me and helped with my claim. We got the win last week and it was the best news I have gotten considering how much my life has... been turned upside down the past 2 years. Emma and Rebecca have been incredible to work with and explained everything from the start even when I had hesitation to go ahead regarding how much everything would cost or how fair it could go or even if I had a chance, but they explained everything thoroughly, so I understood it all. Thank you for making this process seamlessly easy and helping me get the win it will make things a little easy for me that's for sure financial thank you for all your help I cannot recommend you and your services enough. Thank you again.read more
Sigrid W.
05:01 11 Apr 24
Utter professionalism from first phone call to final settlement. It was a pleasure to be represented by a firm that actually cares for their clients. From office staff, to paralegal and solicitor... Rebecca, Emma and Matthew thank you for your support and expertise throughout my claim. No wonder your firm has won many awards. I'm extremely happy with my outcome and can confidently recommend your firm.read more
BJ S.
01:09 09 Apr 24
Highly recommend Matthew & Allison at Garling and Co ! Quick response ! helpful every step of the way ! If you want the best compensation lawyer, Matthew @ Garling and co is the bestDoesn’t waste... time. Very informative ! excellent guidance! They get the job done ✅Website is perfect guide5 Star ⭐️ is not enoughI’m so grateful to Matthew, Allison and team for my outcome so far !Thank you 😊 Garling and co are awesome 👏 🤩read more
Jaimie K.
06:11 02 Apr 24
Have had a rollercoaster ride with Garling and Co over the several years we have been battling the system that injured workers are faced with. The wheels of progress are slow within this system.... However Garling and co have always stood by me. Calls are returned and matters are always followed up in a timely manner.read more
READ ALL TESTIMONIALS

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Ray H.
07:33 13 Jun 24
Matthew Garling and Team are kind, patient, polite, professional, empathetic and efficient. I was treated terribly by the at fault insurer. Garling and Co. had my back. Matthew gently and patiently... kept me up to speed on all the steps to go through. From my personal experience I recommend these guys. They are safe hands. Thank you team.read more
Jo L.
05:58 07 May 24
So very impressed with the professional team who looked after me throughout the last 4 and 1/2 years. A special mention to Kerry and Nathan who navigated each request to fight for my right to gain... access to further treatments and physio and to ensure medical treatment would be covered moving forward. I was so grateful I could hand it all over to you and not have to go through this very challenging time without your support.I thank you for the compassion you have provided to me, from the first contact with Matthew and Natasha, to finalisation with Kerry and Nathan.I highly recommend the team at Garling and Co for any third party compensation claims. You are in good hands with them all.read more
Linda O.
21:53 06 May 24
Emma, Rebecca and the team at Garling and Co have worked diligently throughout my workers compensation claim. The level of professionalism, support and communication has been faultless. Of particular... note has been the sensitivity displayed to me throughout the lengthy process. Worker’s compensation claims are complex and not easy to navigate, particularly when you are unwell. I do not hesitate to recommend Garling and Co to help you find a way through this otherwise unfathomable system.read more
Keith H.
20:51 23 Apr 24
After my case stalled with another firm, I decided to give Matthew Garling a call. He took my case and not only won, but achieved an outcome that far exceeded my expectations. This firm is the best... in the business in my opinion and I wouldn't hesitate to recommend them to anyone.read more
Anthony T.
00:50 16 Apr 24
Thank you Matthew and his team who guided me through the legal process, a truly positive experience with total professionalism.
Mikaele N.
03:01 15 Apr 24
Garling &Co Lawyers were awesome, I called every compensation law firm and was told that I couldn't claim for compensation.The whole experience and process was simple and stress free.Mr Matthew... Garling and Allison deserve an accolades for the very best in client service. I would highly recommend their service to anyone.read more
Tamara L.
02:10 15 Apr 24
I want to thank Garling & Co so much for all the help they have given me and helped with my claim. We got the win last week and it was the best news I have gotten considering how much my life has... been turned upside down the past 2 years. Emma and Rebecca have been incredible to work with and explained everything from the start even when I had hesitation to go ahead regarding how much everything would cost or how fair it could go or even if I had a chance, but they explained everything thoroughly, so I understood it all. Thank you for making this process seamlessly easy and helping me get the win it will make things a little easy for me that's for sure financial thank you for all your help I cannot recommend you and your services enough. Thank you again.read more
Sigrid W.
05:01 11 Apr 24
Utter professionalism from first phone call to final settlement. It was a pleasure to be represented by a firm that actually cares for their clients. From office staff, to paralegal and solicitor... Rebecca, Emma and Matthew thank you for your support and expertise throughout my claim. No wonder your firm has won many awards. I'm extremely happy with my outcome and can confidently recommend your firm.read more
BJ S.
01:09 09 Apr 24
Highly recommend Matthew & Allison at Garling and Co ! Quick response ! helpful every step of the way ! If you want the best compensation lawyer, Matthew @ Garling and co is the bestDoesn’t waste... time. Very informative ! excellent guidance! They get the job done ✅Website is perfect guide5 Star ⭐️ is not enoughI’m so grateful to Matthew, Allison and team for my outcome so far !Thank you 😊 Garling and co are awesome 👏 🤩read more
Jaimie K.
06:11 02 Apr 24
Have had a rollercoaster ride with Garling and Co over the several years we have been battling the system that injured workers are faced with. The wheels of progress are slow within this system.... However Garling and co have always stood by me. Calls are returned and matters are always followed up in a timely manner.read more
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
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