Top Mistakes to Avoid When Submitting a TPD Claim

Filing a Total and Permanent Disability (TPD) claim can be a lifeline for Australians who are no longer able to work due to illness or injury. However, the process is not always straightforward.

Claimants in Queensland often face hurdles that can delay or even derail their claims. Understanding the common TPD claim mistakes and learning how to avoid them can significantly improve your chances of success.

This article will highlight the most frequent errors made during the TPD claim process, offer tips on how to correctly fill out a TPD form, and provide strategies to help you lodge a successful TPD claim. 

1. Incomplete or Incorrect Documentation 

One of the most common mistakes is submitting incomplete or incorrect documentation. TPD claims rely heavily on medical reports, employment records, and insurance documents. Missing or inconsistent information can raise red flags and lead to unnecessary delays. 

How to get it right:

• Double-check all documentation before submission. 

• Ensure medical reports are up-to-date and clearly describe the extent of your disability. 

• Include a detailed employment history and evidence that supports your inability to work. 

• Consult with a legal expert to ensure all paperwork meets the insurer's requirements. 

2. Misunderstanding Policy Definitions 

Each superannuation fund or insurance policy may define "total and permanent disability" differently. Some policies require that you are unable to work in any occupation, while others may only consider your usual occupation. 

How to get it right: 

• Read your policy documents thoroughly. 

• Understand whether your claim falls under "own occupation" or "any occupation". 

• Seek legal advice if the wording is unclear or ambiguous. 

3. Failing to Seek Legal Advice Early 

Many claimants attempt to navigate the process alone, only to run into legal and procedural issues. Insurers may reject claims due to technicalities or insufficient evidence, which could have been avoided with professional assistance. 

How to get it right: 

• Engage a lawyer experienced in Queensland TPD claims as early as possible. 

• Legal experts can assess your eligibility, gather supporting documents, and liaise with insurers on your behalf. 

• They can also help appeal denied claims. 

TPD lawyers like Sarinas Legal specialise in guiding clients through the complexities of the claim process. 

4. Delaying Your Claim 

Waiting too long to start your TPD claim can have serious consequences. There are often time limits imposed by superannuation funds or insurers, and delays may weaken your case. 

How to get it right:

• Start the claim process as soon as you become aware that you may be permanently unable to work. 

• Notify your insurer or super fund immediately. 

• Keep records of all communications and documents. 

5. Not Providing Sufficient Medical Evidence 

Your claim must be backed by strong medical evidence from qualified professionals. Some claimants submit reports that are vague, outdated, or from practitioners not familiar with their full medical history. 

How to get it right: 

• Get detailed reports from treating doctors, specialists, and allied health professionals. 

• Include test results, hospital discharge summaries, and ongoing treatment plans. 

• Ensure that the evidence aligns with the criteria set out in your policy. 

6. Overlooking the Impact of Non-Medical Factors 

While medical evidence is crucial, insurers also consider other factors like your education, work history, age, and skills. Ignoring these can make your claim less persuasive. 

How to get it right:

• Provide a comprehensive personal profile. 

• Explain how your disability affects your daily life and ability to perform any work. 

• Support your statements with documents such as Centrelink correspondence or occupational assessments. 

7. Poorly Completed Claim Forms 

The TPD claim form is a critical document. Any errors, omissions, or inconsistencies can lead to delays or denials. Some claimants rush through the form or misunderstand what is being asked. 

How to get it right: 

• Take your time when filling out the TPD form. 

• Answer every question thoroughly and truthfully. 

• If unsure, ask for clarification or seek legal help. 

A legal expert can review the form before submission to ensure it reflects your circumstances accurately. 

8. Failing to Disclose Pre-existing Conditions 

Some claimants fear that disclosing pre-existing conditions will harm their claim. However, failing to disclose them can be much more damaging if the insurer discovers them independently. 

How to get it right: 

• Be honest and upfront about your medical history. 

• Provide context for any pre-existing conditions and how they relate (or don’t relate) to your current disability. 

• Let your legal advisor handle sensitive disclosures in the best way possible. 

9. Assuming a Rejected Claim Means the End 

A rejected TPD claim can be disheartening, but it doesn’t always mean the end of the road. Many claims are initially denied but succeed on appeal.

How to get it right: 

• Request a copy of the insurer’s reasons for denial. 

• Review the decision with a legal expert. 

• Prepare additional evidence or submit a formal complaint through the Australian Financial Complaints Authority (AFCA) if necessary. 

10. Not Keeping Copies of Documents and Communications 

Losing track of your claim documents or email correspondence can be costly. You need a clear record of everything you’ve submitted and discussed with insurers or legal representatives. 

How to get it right: 

• Maintain a dedicated folder (physical or digital) for your TPD claim. 

• Keep copies of all forms, reports, and letters. 

• Document all phone calls, including dates, names, and discussion points. 

Final Thoughts: Maximise Your TPD Claim Success

Navigating the TPD claim process in Queensland can be challenging, but avoiding these common mistakes will give your claim the best possible chance of success.

From properly completing your forms to securing strong medical evidence and understanding your policy, every detail counts. 

If you're feeling overwhelmed or unsure about any part of the process, don't hesitate to reach out for legal support. Experienced professionals can provide invaluable guidance and advocacy. 

Need Help With Your TPD Claim? 

For tailored advice and support with your Total and Permanent Disability claim, contact Sarinas Legal today. Our experienced TPD lawyers in Townsville are here to help you every step of the way.