In the event of ongoing physical illness or an accident that results in a serious enduring injury, it is well-known that the ill/injured party can seek compensation and file a total and permanent disability (TPD) claim. This can be a huge relief for many, as their condition may prevent them from holding a job or returning to work. However, in this day and age, mental health is becoming increasingly recognized as equally important to physical health. With the improved understanding of the impact of mental health on the rise, many are asking the question whether illnesses that may affect one’s ability to work (such as chronic depression, post-traumatic stress disorder (PTSD), or schizophrenia) are eligible for TPD coverage.
Is Mental Illness Eligible for TPD Coverage?
The short answer: It depends. Your policy will have a list of terms which identify what products and conditions are covered. If you or a loved one is considering filing a TPD claim for a mental condition, the first step will be to explore the terms of coverage in your superannuation policy. In general, serious mental illnesses are covered, but you will have to demonstrate that you meet the requirements outlined in your policy.
What will a TPD Claim Require for Mental Illness Coverage?
All TPD claims require that you demonstrate that you are unable to work and that your illness, injury, or condition is the underlying cause of your inability to work. However, mental health TPD claimants are held to a higher standard of proof. Though the claims tend to be complicated, many who have received regular treatment from their General Practitioner, a psychologist, and/or a psychiatrist will be successful in providing the requisite evidence needed to support a TPD claim.
What Conditions may be covered by TPD?
Many different conditions may be covered under your superannuation TPD policy, below are some of the most commonly cited conditions. (Note: this list is not exclusive; other conditions may be included. Ask a trained TPD lawyer about your unique circumstances as soon as possible.)
- Post-Traumatic Stress Disorder (PTSD): A condition common with ex-military or emergency service personnel, PTSD is characterized by severe stress reactions that are a result of experiencing or witnessing traumatic events. Those with PTSD may experience a range of extreme emotions, including fear, anger, and grief. Many with PTSD also experience symptoms of depression, bipolar disorder, anxiety, or panic disorder.
- Depression: This condition is characterized by all-consuming feelings of defeat, sadness, guilt, and/or apathy that do not fade over time. Depression is often cyclical; with the individual feeling better and able to go about daily life in between experiencing depressive symptoms and an inability to function as they normally would. Depression is common and comes in many different levels of severity, often increasing the likelihood of drug or alcohol abuse. At its most intense, depression can include thoughts of suicide. Related conditions include: manic depression, bipolar disorder, among others.
- Anxiety & Panic Disorders: Also very common, anxiety and panic disorders often involve an involuntary overreaction to your body’s fight-or-flight adrenaline response. These conditions cause overwhelming feelings of fear, worry, paranoia, and stress. These episodes of worry can last for long periods of time and can include symptoms such as insomnia, sleep-paralysis, heart palpitations, stomach aches, dizziness, hyperventilation, numbness, and more. Panic disorder and attacks are more intense than anxiety disorder and attacks, with symptoms typically being more intense and prolonged. Anxiety and panic can contribute to depression and other mental conditions.
What Will I Need for a TPD Claim?
First, you will need to fill out a claims form for your super fund. They will require you to submit a variety of documents detailing things such as your work history, educational background, financial records, and medical evidence supporting your claims. Contact an experienced TPD lawyer as soon as possible to receive advice about your circumstances and to support your best chance at a successful TPD claim.