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Making a TPD Claim for Mental Illness.

Mental illness can be completely debilitating, and many people suffering from mental illness find themselves unable to work. To make matters even worse, people with mental health issues often experience significant levels of stigma and discrimination. For example, according to Beyond Blue, a common attitude is that people with anxiety or depression are ‘weak, not sick’. But people who understand mental illness know that you can’t simply ‘get over it’, and serious mental illnesses can prevent you from working.

Fortunately, in Australia there’s a financial safety net for people who are unable to work due to illness or injury. Most superannuation policies include TPD (total and permanent disability) insurance, which pays you a lump sum if you’re unable to work through a TPD claim for mental illness.

Making a TPD Claim for Mental Illness.

I can’t work because of my mental illness. What do I do?

The first step is to get some professional help and a diagnosis for your condition, and the best place to start is a trusted GP. For more information on getting help refer to this article from the Black Dog Institute.

If your mental illness has developed as a result of your job you might be eligible to make a claim for workers compensation. For example, if you’ve developed PTSD from witnessing a traumatic event in the course of your job, and you need time off work, you can make a workers compensation claim. For more information you can read our guide to workers compensation claims.

If it’s unlikely that you’ll be able to return to work at all, you should also find out whether you can make a TPD claim for mental illness.

Can I make a TPD claim for mental illness?

Here are three questions that will help you determine if you can make a claim:

  1. Were you working in the 12 months prior to your mental illness being diagnosed?
  2. Have been unable to return to work since developing your mental illness?
  3. Do you have superannuation?

If you answered yes to these questions, then it’s likely you can make a TPD claim for mental illness.

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Which mental health conditions are covered by TPD insurance?

Any mental illness that prevents you from returning to work may qualify for a TPD claim for mental illness. Here are some examples of mental health problems that could prevent you from working:

Post-traumatic stress disorder (PTSD): PTSD is a disorder triggered by witnessing or experiencing a terrifying event. It can last for months or years, with triggers that can bring back memories of the trauma alongside intense emotional and physical reactions.

Persistent anxiety: Severe, persistent and disabling anxiety can make everyday tasks like leaving the house to go to work impossible. It can also cause breathing difficulties, sweating and fluctuations in heart rate.

Depression: In its most severe form, depression and major depressive disorders can make it impossible for a person to properly function, and this includes going to work and performing their job role.

Schizophrenia: Schizophrenia is a common mental illness. During the early stage of the illness sleep, emotions, motivation, communication, and ability to think clearly may change. When people with Schizophrenia become unwell this is called an ‘acute episode’, and they may feel panic, anger or depression.

Bipolar disorder: Bipolar disorder is a mental illness marked by extreme shifts in mood. Symptoms can include an extremely elevated mood called mania. They can also include episodes of depression. Bipolar disorder is also known as bipolar disease or manic depression.

Panic attacks: Similar to PTSD, survivors of accidents that caused a life-limiting injury or illness may have persistent panic attacks triggered by sights, sounds, or smells that remind them of their accident.

Physical symptoms induced by mental illness: These can include headaches, dizziness, chest pain, nausea and muscle tension. Mental health conditions can also worsen conditions such as heart disease, high blood pressure and asthma.

There’s no defined “list” of conditions that can be used to support a TPD claim for mental illness—the key is that you’ve developed a mental health condition that has stopped you from returning to work.

How do I know if my insurance covers a TPD claim for mental illness?

TPD insurance covers all injuries, both physical and psychological. Physical injuries can often lead to some form of damage to psychological health, and insurers know and account for this.

In short, if you’ve got TPD cover under a superannuation fund, employment, a union, a financial institution or any other means, you’ll be covered for a TPD claim for mental illness.

To find out what TPD cover you have with your superannuation funds, refer to your member statements. If you need help you can call 13 15 15 and one of our TPD specialists will check for you – it’s a free service.

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Does it matter what caused my mental illness?

No, it doesn’t matter. Whether your mental illness has been caused by a traumatic event, developed over time or come on suddenly and out of the blue, if it has forced you to stop working then you can lodge a TPD claim for mental illness.

The main consideration when you make a TPD claim for mental health is that your capacity as a worker has been diminished or eliminated due to your mental illness.

How do I make a TPD claim for mental illness?

To make a successful TPD claim for mental illness, you’ll first need to contact your superannuation fund. They’ll begin by asking you to fill out a number of forms and carry out an initial assessment. Following this, your TPD claim for mental illness will be passed onto the insurer who’ll carry out their own assessment and come to a decision.

The key to a successful TPD claim is completing a thorough application that provides all the necessary documents and evidence to substantiate your claim. That way, you spend less time going back and forth responding to requests for more information and evidence and give your claim a much higher chance of being approved.

Where can I get help with my TPD claim for mental illness?

Although mental health is covered under TPD insurance, these claims can be harder to prove compared to physical injuries or illnesses. Claims can become complicated and drawn out.

Because of this, many people choose to get help from a TPD claim specialist to manage their TPD claim for mental illness on their behalf.

A TPD specialist will make sure that your claim is prepared thoroughly to meet all your insurer’s requirements, includes all the required evidence, and is assessed as quickly as possible.

Law Partners is Australia’s largest specialist personal injury firm, and we have a number of TPD specialists who can manage your claim for you, wherever you are in Australia.

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