Whether you’re at the start of your TPD journey or feeling lost in paperwork, this guide will walk you through what to do, and how to do it right.

If you’ve suffered a serious injury or illness that stops you from working, a Total and Permanent Disability (TPD) claim can offer much-needed financial support. But the process isn’t always simple.

From understanding waiting periods to navigating complex definitions of “disability,” every detail matters. And if you miss a step, insurers may use it to delay or deny your claim.

This guide breaks down everything you need to know about making a TPD claim in Australia. Whether you’re wondering about mental health coverage, age limits, or whether to get legal help, we’ve got your back.

At Gordon Legal, we stand with workers and everyday Australians, not insurance companies. Here’s how to claim what’s rightfully yours.

Are there any waiting periods before I can lodge a TPD claim?

Yes, most TPD insurance policies include a waiting period, often around three to six months from when you last worked. This is to confirm that your condition is indeed long-term and prevents you from returning to work.

Key points to check:

• Your last day at work
• Whether your super fund has specific time frames
• If your medical condition has stabilised

The waiting period can vary, so check your policy’s fine print or get legal advice to confirm.

Your work history helps insurers assess your capacity to return to work. Some policies cover you if you can’t do your own job, while others only pay if you can’t do any job you’re reasonably trained for.

Your employment history shows:

• The type of work you’ve done
• Your training and qualifications
• The consistency of your employment

The more clearly you can show how your condition affects your work abilities, the stronger your claim will be.

Most superannuation-based TPD policies have age limits, often between 65 and 70 years old. Once you reach that age, your TPD cover may cease automatically.

Before lodging a claim, always check:

• If your TPD cover is still active
• The age cut-off listed in your super fund policy
• Whether you had insurance at the time of injury or illness

You don’t legally need a lawyer, but having one can dramatically increase your chances of success. TPD claims are full of technical definitions, medical requirements, and strict procedures.

A good lawyer will:

• Review your policy and eligibility
• Gather strong medical and employment evidence
• Make legal and policy submissions on your behalf
• Handle communication with insurers
• Appeal if your claim is delayed or denied

At Gordon Legal, we work on a No Win, No Fee basis, so you only pay if your claim is successful.

This is a crucial point. Each insurer or super fund has its own definition of “Total and Permanent Disability”, and it’s often far from straightforward.

Common definitions include:

• Unable to work in your usual job again
• Unable to work in any occupation you’re trained for
• Suffering from a severe impairment or needing ongoing care

The definition used will affect whether your claim is approved, to make sure you understand exactly what your policy says.

To give your TPD claim the best chance of success:

• Get clear and current medical reports from your treating doctors
• Include statements from past employers
• Collect your full work history and education records
• Write a personal impact statement explaining your daily limitations
• Ensure your paperwork matches your policy’s wording

Bonus tip: Ask your GP or specialist to complete insurer-specific medical forms—they carry more weight than generic letters.

Yes, this is essential. Your treating doctors can give detailed insights into your diagnosis, prognosis, and work limitations.

You’ll usually need:

• A medical certificate or report confirming your condition
• Functional capacity reports (e.g. physical or psychological assessments)
• A statement on your ability to return to work

Insurers are more likely to approve claims supported by comprehensive medical documentation.

Yes—mental health conditions can be covered under TPD, just like physical injuries. However, these claims can be more complex.

Common eligible conditions include:

• PTSD
• Major depressive disorder
• Anxiety disorders
• Bipolar disorder

You’ll need strong documentation from psychiatrists or psychologists, and evidence that the condition prevents you from returning to work permanently.

Once your claim is submitted, the insurer must provide regular updates. You can request:

• A copy of your claim file
• A timeline of expected decisions
• The name of your claims manager

If delays stretch beyond reasonable timeframes (usually 6 months), speak to a legal expert. You have the right to transparent communication and fair treatment.

Insurers will review your:

• Medical records
• Work history and qualifications
• Any vocational assessments
• Specialist reports
• Statements from you and your employer

They’re trying to determine if you could work again, in any job you’re trained for, not just your usual role. The more clearly your documents show that returning to work isn’t possible, the stronger your claim.

Making a TPD claim can be daunting, especially when you’re also facing illness, pain, or uncertainty about your future. But you don’t have to do it alone.

At Gordon Legal, we’ve helped thousands of Australians secure the TPD payouts they were owed, even when insurers pushed back. We’ll stand beside you, cut through the complexity, and fight for what’s fair.

Get in touch today for a free consultation. We’ll review your policy, help you gather the right documents, and walk you through every step of the claim.

Let’s make sure you get the support you deserve.