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If you have a mental illness, you’ll know how completely debilitating it can be, and how a mental illness can make it difficult, or even impossible to continue working.
You’ll also know that people with mental health issues like depression often experience significant levels of stigma and discrimination. According to Beyond Blue, a common attitude is that people with anxiety or depression are ‘weak, not sick’. But people who’ve experienced or really understand mental illness know that you can’t simply ‘get over it’.
Fortunately, in Australia, there’s a financial safety net for you if you’re 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 have to stop work.
In this article, we explain everything you need to know about TPD claims for mental illness, including:
In our experience with TPD claims for mental illness, you’re likely to be in one of the following three situations:
If you’ve had to stop work and you suspect you’re suffering from a mental illness, your first step is to get a diagnosis. Even if your employer or others have told you that what you’re suffering is normal stress for the job you’re doing, getting a proper diagnosis is important, and an essential first step for a TPD claim.
If you have a mental illness but you haven’t been told you need to stop work you might feel like you have no option but to soldier on, even though you’re struggling. You can only make a TPD claim if your illness stops you from working, so it’s important you get the right assessment from a medical professional. If it confirms your inability to work, then you may be eligible to make a TPD claim.
If you’ve been told you have a mental illness and you can’t work anymore then your next step is to put in your TPD claim. However, there could be multiple claims that you’re eligible for – you might be able to claim TPD through multiple super funds, or if your work caused your illness then you might also be eligible for workers compensation. We can guide you through the process to make sure you get all the compensation and lump sums you’re entitled to.
Whatever situation you’re in, read on to learn whether you can claim TPD, and how to get help with your claim.
Any mental illness that prevents you from working may qualify for a TPD claim for mental illness, and that includes PTSD, depression, anxiety and bipolar. However, just being diagnosed with one of these conditions doesn’t mean you automatically qualify for a TPD claim. To be eligible for a TPD claim, you’ll need a diagnosis that shows your condition interferes with your cognitive, emotional, or social abilities to the point where you’re considered totally and permanently disabled under the definition in your TPD policy.
As you can imagine, providing this proof to the TPD insurer isn’t simple, but read on to learn more about common claims, how to make a successful claim, and how to get help with your claim.
PTSD is one of the most common TPD claims we help people with. PTSD is a disorder triggered by witnessing or experiencing a terrifying event or series of events over time. It can last for months or years, with triggers that can bring back memories of the trauma as well as intense emotional and physical reactions.
If you’ve been diagnosed with PTSD and can’t work anymore or can only manage to work in a reduced capacity you might be eligible to claim on your TPD insurance.
You’ll need to prove that your condition interferes with your cognitive, emotional, or social abilities and you’re considered totally and permanently disabled under the definition in your TPD policy.
Call 13 15 15 or chat to us now for free advice
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Get startedIn their most severe forms, depression, major depressive disorders, anxiety, and bipolar disorder can make it impossible to properly function, and this includes going to work and performing your job role. Anxiety can also cause problems such as breathing difficulties, sweating, and fluctuations in heart rate. 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.
If you suffer from depression, anxiety, or bipolar disorder and this has stopped you from working, you may be eligible to make a TPD claim.
We’ve covered PTSD, depression, anxiety, and bipolar disorder above, but 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:
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.
Similar to PTSD, survivors of accidents that caused a life-changing injury or illness may have persistent panic attacks triggered by sights, sounds, or smells that remind them of their accident.
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 specific “list” of mental health conditions that qualify for a TPD claim for mental illness. As long as you’ve been diagnosed with a mental health condition that prevents you from continuing to work, then you may qualify for a TPD claim.
Here are three questions that will help you determine if you can make a claim:
If you answered yes to these questions, then it’s likely you can make a TPD claim for mental illness.
Your mental illness doesn’t need to be work-related to qualify for a TPD claim. It’s not the cause of your condition that makes you eligible; it’s the impact on your ability to work.
Here are three simple steps you can take:
The best place to start is to talk to your GP. For more information on getting help refer to this article from the Black Dog Institute.
Check your superannuation fund documents to see what TPD cover is included. Sometimes it can be hard to work out how much TPD cover you have, as you may have multiple super funds and TPD policies from changing jobs over the years. If you need help, call 13 15 15 and we’ll find out for you. It’s a free service.
Check the terms of your policy (or policies) to understand whether your mental illness qualifies for a claim. It’s important to note that the definition of TPD payout requirements can vary between policies – for example, your policy might cover you for:
Call 13 15 15 or chat to us now for free advice
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Get startedThe following two case studies are examples of how we help our clients with TPD claims.
Sandra, 38, was involved in a serious car accident and suffered a compound fracture of her leg. Despite a number of surgeries and extensive treatment, tragically Sandra’s leg had to be amputated.
As is the case with many amputees involved in car accidents, Sandra developed Post Traumatic Stress Disorder. This mental illness combined with her physical disability made it virtually impossible for Sandra to return to work.
Sandra knew about TPD and decided to pursue claims on her two superannuation policies. But the insurer denied her claims on the basis that she failed to submit enough medical evidence supporting her psychological injury.
Sandra contacted Law Partners, and we immediately arranged for Sandra to be assessed by an independent psychologist, completed a thorough application on her behalf, and wrote a submission to the super fund outlining why Sandra’s claim should be approved.
In just a few months, we overturned the insurer’s decision and Sandra was rightfully awarded an $800,000 TPD payout on her two eligible superannuation policies.
Ali’s ordeal began when he was rear-ended by another vehicle on the motorway while driving home from university. He was left with physical injuries to his neck, lower back, and arm, but fortunately, these were relatively minor.
However, due to the accident, Ali’s mental health deteriorated leaving him unable to attend his full-time uni course, or his two part-time jobs on weekends. His psychiatrist diagnosed him with PTSD, and soon after Ali reached out to Law Partners for help with his CTP motor vehicle accident compensation entitlements which included money for lost wages, medical treatment expenses, and pain and suffering.
But Ali’s condition worsened over several months. He was suffering from social isolation, sleep deprivation, depression, anxiety, and flashbacks to the accident which left him unable to drive or work. We identified that Ali could be entitled to a lump sum TPD insurance payout.
Our TPD specialists got to know Ali personally and listened to his story. We recognised Ali had a legitimate case, but one that would be difficult to manage on his own. Psychiatric TPD claims can be extra challenging for people to navigate without expert legal help, especially for someone as young as Ali, as insurers can be reluctant to approve a payout based on a permanent injury. We were happy to manage the entire claims process for Ali.
We gathered a range of medical and psychiatric reports and prepared detailed statements from Ali to assist our case. The insurer approved our claim, and we got Ali a TPD payout of just over $629,000.
TPD insurance covers all injuries, both physical and psychological. Physical injuries can often lead to some form of damage to mental health, and insurers understand this and account for it in their policies.
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.
If you need help you can call Law Partners on 13 15 15 and one of our TPD specialists will review your cover and explain your full lump sum entitlements – it’s a free service. Law Partners have TPD lawyers based in Sydney and Melbourne ready to help.
No, it doesn’t matter, and it doesn’t have to be work-related to qualify for a TPD claim. Whether your mental illness was caused by a traumatic event, has developed over time or come on suddenly and out of the blue, if it’s been diagnosed and 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.
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 to carry out their own assessment and come to a decision.
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 as insurers may dispute your eligibility to claim or ask for further evidence to back up your claim. As a result, many people abandon their claims out of frustration.
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 from the insurer for more information and evidence and give your claim a much higher chance of being approved.
A TPD claim specialist can manage your TPD claim for mental illness on your behalf. A good TPD specialist will make sure your claim is prepared thoroughly to meet all your insurer’s requirements, includes all the required evidence, and is assessed and approved as quickly as possible.
Law Partners is Australia’s largest specialist personal injury firm, and we have a team of TPD specialists who can manage your claim for you, wherever you are in Australia. We work on a no win no fee basis, and we win over 99% of our cases.
Shane Butcher
Principal
An accredited specialist in personal injury law and spokesman for the Australian Lawyers Alliance, with the best part of 20 years’ experience in assisting injured Australians to receive everything they’re entitled to.
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