Disclaimer – This article is general information and education only. It is not financial or legal advice. Every TPD claim is different, depending on the policy wording, medical evidence, and personal circumstances. For advice about your specific case, please consult a superannuation/insurance-claims lawyer.
Filing a Total and Permanent Disability (TPD) claim can be daunting. Many Queenslanders wonder what insurers are really looking for and why some claims are approved quickly, while others are delayed or rejected.
The truth is, successful TPD claims tend to share common factors: clear medical evidence, consistency, and careful preparation.
In this guide, we identify the most crucial elements that typically contribute to a successful claim, including:
- The main ingredients of a strong claim.
- Evidence types insurers heavily rely on.
- Real-life examples of successful claims.
- Pitfalls that reduce your chance of approval.
What makes a successful TPD claim?
| Factor | Why it matters |
|---|---|
| Active insurance cover | You must have had TPD cover in place at the date you stopped working (date of disablement). |
| Permanent incapacity | Medical evidence must show you are unlikely to return to work in your own occupation (or any occupation, depending on policy). |
| Strong medical reports | Detailed reports from specialists carry more weight than GP notes alone. |
| Waiting period met | Most policies require 3–6 months off work before a claim is lodged. |
| Consistency across evidence | Medical records, employer statements, and claim forms must align. |
| Vocational assessments | Reports that show retraining or light duties are not realistic can support your claim. |
| Legal guidance | Lawyers ensure evidence is strong and help challenge unfair insurer tactics. |
✅ The more comprehensive and consistent your claim, the less opportunity insurers have to reject it.
Key types of evidence
| Evidence type | Examples | Purpose |
|---|---|---|
| Medical reports | GP notes, specialist reports (orthopaedic, psychiatric, neurological, cardiology, oncology) | Demonstrate diagnosis, prognosis, and permanency. |
| Functional capacity assessments | Independent reports on lifting, sitting/standing tolerance, memory, stamina | Provide objective proof of limitations. |
| Employment records | Employer statement, payroll data, position description | Confirm last date worked and nature of job you can’t return to. |
| Superannuation/insurance documents | Policy wording, insurance schedule, cover confirmation | Prove you had active cover when you stopped work. |
| Vocational assessments | Analysis of skills, education, retraining potential | Counters insurer arguments about “light duties.” |
Case studies: approved TPD claims
| Example | Facts | Timeline | Outcome |
|---|---|---|---|
| Back injury claim | Michael, 45, builder. Chronic spinal disc damage made lifting unsafe. Specialist reports consistent. | 9 months | Claim approved, $380,000 payout. |
| Mental health claim | Sarah, 34, nurse. Severe PTSD and depression after workplace trauma. Psychiatric evidence confirmed permanence. | 12 months | Approved after vocational assessment confirmed she could not retrain. |
| Cancer claim | John, 52, diagnosed with advanced cancer requiring ongoing treatment. Clear prognosis from oncologist. | 5 months | Fast-tracked, payout approved. |
| Stroke claim | Anne, 56, teacher. Stroke caused speech and mobility impairments. Neurologist and occupational therapy reports provided. | 10 months | Claim approved, lump sum credited to super. |
Pitfalls that prevent success
❌ Submitting vague GP notes only – insurers want detailed reports from treating specialists.
❌ Inconsistent evidence – mismatches between what you tell doctors, your claim form, and employer statements raise red flags.
❌ Ignoring vocational reports – insurers often argue you can retrain unless evidence proves otherwise.
❌ Lodging too early – most policies require 3–6 months off work before applying.
❌ Overlooking multiple funds – many Australians hold more than one super account with insurance. You may have more than one valid claim.
Checklist: factors that improve approval odds
✅ I had active TPD cover when I stopped working.
✅ My condition is permanent and supported by detailed specialist reports.
✅ I have been off work for at least 3–6 months.
✅ My employer has provided clear records of my role and last work date.
✅ Vocational evidence shows retraining or light duties are not realistic.
✅ I’ve had legal advice to ensure my evidence is consistent and strong.
FAQs
Do I need to be totally bedridden to qualify?
No. Many successful claims involve conditions that prevent sustained employment but do not confine the person to bed.
Can I claim for mental health conditions?
Yes. Mental health illnesses such as depression, PTSD, and anxiety are among the most common successful claims in Queensland.
Does my employer have to support the claim?
Not directly. Employers simply provide factual records. Success depends on your medical and vocational evidence, not employer opinions.
Can I succeed without legal help?
Some people do, but legal advice increases the likelihood of success, reduces delays, and helps challenge insurer pushback.
Key takeaways
- Successful TPD claims require active insurance cover, specialist medical evidence, and consistency across all documents.
- Specialist and vocational reports carry more weight than GP notes alone.
- Consistency between medical, employment, and personal evidence reduces rejection risk.
- Legal advice strengthens your claim and speeds up the process.
A successful TPD claim can be a life-changing event for Queenslanders permanently unable to work. While no claim is ever guaranteed, certain factors – clear evidence, permanency, and consistent documentation – give you the strongest chance of approval.
At TPD Claims Lawyers, we help clients across Queensland prepare strong claims and fight for their entitlements. If you are thinking of lodging a claim or have concerns about your eligibility, contact us today for a free, no-obligation consultation.
Last updated: 8 September 2025