Disclaimer – This article is for general information and education purposes only. It is not legal or financial advice. Eligibility for a TPD claim due to asthma, COPD or other chronic lung disease depends on policy wording, medical evidence, and work history. For advice specific to your situation, speak to a superannuation/insurance-claims lawyer.
Asthma, chronic obstructive pulmonary disease (COPD), emphysema, pulmonary fibrosis and other chronic lung conditions affect thousands of Queenslanders.
For many, regular treatment allows them to manage symptoms and continue working. However, some develop such severe limitations – breathlessness, frequent hospitalisations, oxygen dependence and fatigue – that working safely becomes impossible.
At this point, many ask:
“Can I claim TPD for my respiratory condition?”
The answer: Yes – if your condition permanently prevents you from working in any suitable role and your medical evidence demonstrates this clearly.
This guide covers:
- When chronic respiratory conditions may qualify for a TPD claim.
- How insurers assess these claims.
- Common arguments insurers use to reject respiratory TPD claims.
- Real case examples in Queensland.
- Mistakes to avoid and how to protect your claim.
When do respiratory conditions qualify for TPD?
To make a claim, you must meet your policy’s definition of “total and permanent disablement.” This usually means being unable to:
- Return to your own occupation (own occupation policies), or
- Perform any job for which you are reasonably suited by education, training, or experience (any occupation policies).
| Condition | Impact on work | When TPD may apply |
|---|---|---|
| Severe asthma | Frequent hospitalisations, intolerance to workplace triggers (dust, chemicals) | Eligible if incapacity is permanent and prevents regular attendance |
| COPD/emphysema | Oxygen dependence, breathlessness, fatigue | Often eligible if certified irreversible and prevents sustained work |
| Pulmonary fibrosis | Reduced lung capacity, progressive scarring | Eligible once progression and permanency are confirmed |
| Occupational lung disease (silicosis, asbestosis) | Severe coughing, reduced stamina, long-term complications | Strong grounds if specialist confirms permanency |
| Other chronic lung conditions | Bronchitis, interstitial lung disease | Eligible if the condition makes ongoing safe work impossible |
✅ Both chronic progressive decline and severe acute failure may support a claim.
❌ Mild, well-controlled asthma or occasional flare-ups usually won’t.
How insurers assess respiratory TPD claims
| Factor | What insurers look at | Why it matters |
|---|---|---|
| Policy definition | Own occupation vs any occupation vs ADL test | Determines the threshold for eligibility |
| Diagnosis | Confirmation by a respiratory physician or pulmonologist | GP notes alone are rarely sufficient |
| Treatment history | Use of inhalers, oxygen therapy, rehabilitation programs | Non-compliance is a common rejection ground |
| Permanency | Evidence of irreversible loss of lung function | Temporary exacerbations are unlikely to qualify |
| Functional capacity | Pulmonary function tests, spirometry, exercise tolerance | Objective proof of incapacity for sustained work |
Common insurer arguments
- “Condition is manageable with treatment.” Insurers argue inhalers or oxygen therapy may allow ongoing work.
- “Non-compliance.” Missed appointments or failing to follow treatment plans can be used against you.
- “You could do sedentary work.” Even if physical roles are impossible, insurers may argue you can sit at a desk.
- “Condition isn’t permanent.” Early-stage lung disease may be disputed as not meeting permanency requirements.
Evidence that strengthens your claim
| Evidence type | Examples | Purpose |
|---|---|---|
| Specialist reports | Respiratory physician or pulmonologist confirming prognosis | Primary medical evidence |
| Pulmonary tests | Spirometry, FEV1 scores, oxygen saturation | Objective evidence of reduced lung function |
| GP records | Long-term use of inhalers, oxygen, medications | Shows consistency and compliance |
| Hospital records | Admissions for asthma attacks or COPD exacerbations | Demonstrates severity and frequency |
| Functional capacity assessments | Exercise tolerance, stamina, mobility testing | Counters insurer arguments about “lighter duties” |
| Vocational assessments | Transferable skills/retraining analysis | Rebuts arguments about alternative sedentary roles |
✅ Strong, consistent medical and functional evidence significantly improves claim approval rates.
Case examples in Queensland
| Example | Facts | Outcome |
|---|---|---|
| COPD – construction worker | Michael, 58, long-term smoker, diagnosed with COPD. Unable to climb scaffolding or lift heavy loads. | Specialist confirmed permanent incapacity. Claim approved, $380,000 paid into super. |
| Severe asthma – childcare worker | Sarah, 40, frequent hospitalisations triggered by workplace environment. | GP notes insufficient, but respiratory specialist confirmed permanent incapacity. Claim approved on appeal, $250,000 credited. |
| Pulmonary fibrosis – admin worker | Ahmed, 49, oxygen-dependent. Insurer argued he could do “desk work.” | Functional testing and specialist reports overturned rejection. Approved after dispute, $420,000 lump sum paid. |
Pitfalls to avoid
❌ Lodging claims with GP notes only – insurers want specialist evidence.
❌ Applying too early – most policies require 3–6 months off work.
❌ Ignoring vocational assessments – insurers often argue for sedentary roles.
❌ Allowing inconsistencies – ensure GP, specialist, and hospital notes align.
❌ Giving up after rejection – many claims succeed on AFCA appeal or with legal support.
How to protect your claim
| Step | Why it matters |
|---|---|
| ✅ Engage a respiratory specialist | Insurers rely heavily on pulmonologist/respiratory physician evidence |
| ✅ Keep treatment and hospital records | Shows compliance and severity |
| ✅ Apply after waiting period | Avoids early rejection under policy rules |
| ✅ Get functional/vocational assessments | Counters arguments about “lighter duties” |
| ✅ Seek legal advice | Lawyers strengthen claims and challenge insurer disputes |
FAQs
Can asthma qualify for a TPD payout?
Yes – but only if severe, chronic, and permanent. Controlled asthma rarely qualifies.
Does oxygen dependence help my case?
Yes. Oxygen therapy is strong evidence of incapacity.
Do insurers treat respiratory claims differently?
They often argue the condition is “manageable.” You must show permanence with specialist evidence.
Can I claim from multiple funds?
Yes, if you held active TPD cover across multiple superannuation accounts at your disablement date.
Key takeaways
- Chronic respiratory conditions like asthma, COPD, emphysema and pulmonary fibrosis can qualify for TPD.
- Specialist respiratory reports and pulmonary testing are essential.
- Insurers often argue conditions are manageable or sedentary work is possible.
- Vocational assessments and legal advice help counter these arguments.
- Many rejected respiratory claims succeed on appeal.
For Queenslanders with chronic respiratory conditions, safe and sustained employment can become impossible. While insurers often push back, strong specialist evidence, pulmonary function testing, and vocational reports can make the difference between rejection and approval.
At TPD Claims Lawyers, we regularly help Queenslanders with asthma, COPD and other respiratory conditions secure payouts. We prepare robust claims, challenge insurer pushback, and fight for the entitlements our clients deserve. Contact us today for a free, no-obligation consultation about your claim.
Last updated: 8 September 2025