FAQ

Find answers to some of the more frequently asked questions on the Forums.

Forums guidelines

Our guidelines keep the Forums a safe place for people to share and learn information.

TPD for depression

smith2
Community Member

Hello All,

I've been off work with a major depressive disorder for 20 months, my employer (a well known multinational) instructed me to attend an Independence Medical Examination, based on the examination report my employment will be terminated.

Depressed, alone, out of work and with a mortgage is not a good place. I'm about to start a TPD claim in the hope that I can keep my home.

Does anyone have experience with TPD claims, I've read they can be difficult to prove ?

Any advice ?

Regards

41 Replies 41

geoff
Champion Alumni
Champion Alumni

dear Smith, welcome to the site, and your post concerns claiming for a 'total and permanent disability' which I haven't actually had to claim but had to go through all the doctors mostly organised for my benefit by my solicitor and only one by the opposition, as a MRI shows the blood clot I received from an assault at work, never the less it does go on and on.

The injury that you received at work will cease your employment from what I can read, which isn't what you want nor do you want to be sustained with this injury for life.

Insurance companies will easily take our money with no hesitation at all, but when you want to claim, well that's another story, as they find anyway to not pay out.

Before I continue have you claimed any payments from centrelink which can carry you through, and if your mortgage payments are behind then contact your bank and explain the situation.

Google ' Independence Medical Examination' as there maybe some useful information for you, but normally these doctors are organised by the Insurer, but I do hope that you have a lawyer who will help you with this, especially one who deals in these types of claims.

Please let me know what happens and if you want to talk about it. Geoff.

 

Doolhof
Champion Alumni
Champion Alumni

Hi Smith2

I don't know anything about TPD claims, but I do know a bit about depression.

I would just like to know if you are receiving help and assistance with your depression as it sounds like you are going through a rough time and life may become even more "heavy" with the avenue you are about to walk down.

Do you have friends you connect with or family? It is important to keep in touch with people and to do things that you enjoy.

Geoff has given you some good advice on how to proceed from here, so I hope you are able to find the assistance you need to get everything sorted.

Cheers for now from Mrs. Dools (Lauren)

smith2
Community Member

Hello Lauren and Geoff,

Yes Geoff, you are correct the illness will result in my employment being terminated. Up until now I've received an income through my Super insurance scheme and been able to keep up. That ends with the job, therefore the TPD claim to make ends meet.

Haven't claimed from centrelink todate.

Lauren I have been getting weekly medical treatment for depression for near on two years, not sure that there's been any great progress.

Looking like I will have to engage a TPD lawyer on a win no fee basis

Cheers

Smith2

John_
Community Member

Hi Smith2, I am new to this site and in no way an expert but have about 5 years of personal work place bullying and harassment and work cover experience that sounds like it could be similar to yours. If there is one thing I have learnt and been told by numerous Lawyers is that there is NO justice only money on this side of life. Justice only comes in the next life. Make sure you get a law firm on a no win no fee before you fill any forms out for your TPD. As Geoff has said "Insurance companies will easily take our money with no hesitation at all, but when you want to claim, well that's another story, as they find any way to not pay out." They will twist and squirm their way out if at all possible. I have just engaged Lawyers to take up my case with my private income protection company who have accepted my claim and have paid some but are now trying to restrict what they pay me. They are also looking into my Superannuation for a further claim there including TPD. I said to my wife that I was not going to attempt this myself due to my past hassles and it is not good for your health. Give it to an expert and let them do it so you can work on your health and keep your home and family. Generally the Law firm will investigate so far for free and then give you an upfront figure to do the work and you will only need to pay if they are successful. I will be very happy to pay when they are successful for me. There are many other law firms so check them out.  

God Bless and good health.

PS. get your wife to go to her GP and get a mental health plan organised not that she needs it but just to keep her sane while this is going on. Make sure her Dr Notes that she is well but that this is only as a precaution due to the stressful situation. This note on her file may be beneficial for her in the future if any medical investigations of her health for whatever comes up.

 

Doolhof
Champion Alumni
Champion Alumni

Hi Smith2

I don't have anything to add regarding your work and financial situation.

I am sorry to read though that your frequent sessions to help with your depression do not seem to be having a positive effect from what you have written.

Maybe they are a little more effective than you think, but with everything that is going on, you will no doubt be feeling quite over loaded.

Are there some activities that do increase your sense of peace and calmness? I suppose the person you are seeing has offered all kinds of ideas to you, have you found any that work?

I find that just taking a half hour out of a crazy day for a walk helps me.

Thinking of you, from Lauren

 

Turkeyman
Community Member
Really sorry to hear about your situation and I sympathize with the mortgage thing. Be mentally prepare for a long fight, TPD claims even through superannuation can take years, mine is in it's second year now after being rejected once by the insurer but being given a second chance thanks to the superannuation company. If it is a worker's comp situation, it isn't likely to be any easier either so I agree you need a no win no fee lawyer helping. Keep up the good fight, if we don't fight for what is rightfully ours, what good is insurance in the first place?

newbie218
Community Member

Hi Smith2,

I have just successfully won my TPD claim!

I would definitely encourage you to seek the assistance of a lawyer, on a 'no win, no fee' basis to assist you. 

It's extremely important that your treating doctors (ie. Psychiatrist, GP, Psychologists etc) are supportive of your application as they'll be required to complete a medical report to support your TPD claim. So I would encourage you to have a chat to them beforehand.

My claim took 18mths, so it's a long process & hopefully you're in a position mentally and financially to endure the time it takes to process a TPD claim.

As you may read elsewhere on other websites or forums, the insurance companies will try their best to reject your TPD application by sending to their so called 'Independent Medical Examiners (IME)' or find some inconsistencies in your medical history from your doctors reports etc. But don't let this scare you! If your claim is rejected, the insurance company are required to outline their reasons for declining your application & you'll be able to appeal their decision.

In my particular case, my insurance company didn't send me for an IME or reject my claim. They based their decision to approve my TPD claim purely on the extensive medical evidence that was provided, which included 3 Workcover IME reports, 3 Medical reports from my Psychiatrist & 1 report from the Medical Panel. I sincerely believe that my psychiatrist's very detailed & supportive medical report, had the biggest impact in me winning my claim. 

My age (36yo) & my payout amount, were my biggest hurdles to overcome. My lawyers kept telling me that my insurance company would try to use my relatively young age to reject my claim. They were of the belief that the insurance company would try their best to say that I could retrain or that there was no way I could be 'indefinitely' incapacitated with MDD bc I'm so young. Fortunately, my lawyers were able to justify in their submission letter why I wouldn't be unable to retain & return to work. 

It took me 15mths to finally have the courage to lodge a TPD claim & my only regret is that I didn't do it sooner. So I really hope that you don't make the same mistake that I made.

If I can be of any further assistance, if you have any other specific questions about the process, please feel free to ask. 

I hope this reply has been of some help to you & I wish you all the best. 

 

Lcw
Community Member

Hi newbie218

I have been off work for 9 mths originally diagnosed with adjustment disorder with extreme anxiety and depression. I have had 3 independent reviews and see my psyc fortnightly. I feel like my head will explode sometimes  trying to find out how long or what it will take to either recover or get a TPD diagnosis. I am flat out getting out if bed I push myself for those around me sake. My prognosis has gone from 3 to 6 months now out to 6-12 months. I am under extreme financial pressure I was wondering what your journey was like and hope you are keeping on top of things regards Lcw

newbie218
Community Member

Hi Lcw,

I'm sorry to hear that about your circumstances. I can totally relate to how your currently feeling and the experiences that you've been through. In regards to my personal journey, like yourself, I was originally diagnosed by psychiatrist in 2011 to be suffering from an adjustment disorder. That changed about year later to major depression and anxiety and this continues to be my current diagnosis. Since 2011, I have tried over 16 different types of medication without any real success. Actually, several of the anti-depressant caused severe side effects that I required emergency medical treatment. I have also had 5 inpatient psychiatric admissions, pretty much one every year!. Other treatments I've tried include, attending weekly psychotherapy groups, psychological counselling, sleep therapy, hypnotherapy, graded exercise therapy, herbal medication. Most recently, I had ECT, with no success. Like yourself, I have undergone several IME appts arranged by my WorkCover consultant. My treating psychiatrist has also sent me to about 5 other psychiatrist for "second opinions", mainly for advice on medication interventions. I can empathise with you, your frustrations regarding your journey to recovery; not knowing how much longer it'll take to feel better is difficult to deal with. Similarly, the financial pressures you're experiencing I believe adds a lot of undue stress and hinders your progress to returning to good health.

If you're considering lodging a TPD claim, I would strongly recommend that you seek the assistance of a lawyer. Generally speaking, the definition for TPD is that you'll need to be assessed as being "unable ever again to work for reward in any business, occupation or regular duties for which s/he is reasonably qualified by education, training or experience". I also found that having the support of my treating doctors to be extremely helpful. My treating doctors report was so detailed and supportive that I really feel that it lead to the success of my TPD claim.

I hope my reply has been helpful. If there is anything else that you'd like to know about the TPD process, my journey or anything that may assist with your recovery, please do not hesitate to ask.

Take care x