Claiming TPD while on WorkCover (Vic)

Can I claim TPD while on WorkCover? Yes, you can claim TPD while you’re on WorkCover and in fact it is a good idea to do so. However, it is important to get your timing right.

This article will explain things in more detail.

TPD claims

You’re probably aware of this but just to make sure.

A TPD claim is a total and permanent disability claim.

Think of this as an insurance component that may be attached to your superannuation.

It is insurance cover that you may have been paying for by way of regular deductions from your superannuation to cover you in the event that you become incapacitated and not able to work.

People often have death benefits and income protection benefits as well in addition to TPD.

Not everyone has a TPD component attached to their superannuation.

The TPD insurance amount (the amount that you will be paid if your TPD claim is successful) is not related to the amount that is actually in the super fund.

So it doesn’t matter whether for example you have $10,000 in super or $500,000, the TPD insurance amount remains the same.

TPD and WorkCover in Victoria

During the WorkCover process, to prepare your matter properly it is important that medical material be obtained.

That medical material should address the nature of your injury, the prognosis for your injury, and importantly, the impact that the injury will have your ability work moving forward.

This medical material will be from your treating medical practitioners such as a GP or specialist doctor.

It may also be from medical consultants who have reviewed you and provided an assessment.

Much of this material that is obtained for the purposes of your WorkCover claim can be of benefit if you are pursuing a TPD claim.

Typically, the most helpful material for the purposes of a TPD claim is obtained when preparing a WorkCover common law claim.

And so this information is useful in a TPD claim to give your claim the best chance of being accepted.

For example, a report may be obtained from an occupational therapist who is a specialist doctor that is able to comment on your work skills and the nature of your injury and what your capacity to be for work moving forward may be.

That doctor may even go so far as to looking at the job market and to provide a comment as to what you may or may not be able to do. They may address specific jobs that you are no longer able to do because of your injury.

This will be helpful for a TPD claim.

Another thing that may be helpful is an affidavit which is obtained during the WorkCover process when someone is initiating a common law claim.

An affidavit is a very important document when it comes to a WorkCover common law claim. Quite a bit of time should be spent on an affidavit making it detailed and accurate.

What a good affidavit is designed to do is to paint a before and after picture as to how you were before the injury and how you are now.

It is and should be detailed and address many of the ways that an injury now impacts your life.

It is often very helpful to provide affidavits to the super fund in support of a TPD claim.

For the purposes of a TPD claim, your super fund will likely have forms on which they will want a couple of your doctors to write their medical opinions. These are usually called medical attendant statements.

It is helpful in relation to these medical attendant statements to provide the extra medical material and affidavit referred to above as further support.

Can I lodge a TPD claim earlier?

You certainly can.

You can lodge a TPD claim really at any time (provided that you have been off work for the requisite period of time as specified in the policy, usually a minimum of six months).

However we recommend that in general you wait until you have good medical material obtained during your WorkCover matter before initiating a TPD claim.

Impact of TPD claim on WorkCover claim

Weekly payments

You are able to lodge the TPD claim when you have a WorkCover claim on foot.

However, if you have a WokCover claim on foot and you’re wanting to pursue a TPD claim, you should get legal advice first.

If you succeed in a TPD claim, your entitlement to medical expenses, an impairment benefit and a common law claim – payable under WorkCover – are not impacted.

However, in some cases your entitlement to the payment of weekly payments can be.

It is currently a bit of a grey area.

Common law claim

One thing to keep in mind is that WorkCover and their lawyers will look at all the documents relating to the TPD claim that you made.

They may use anything in the claim to oppose your WorkCover common law claim.

Whether that be a comment made by a doctor on a TPD medical attendants statement, or something else.

Conclusion

Yes, you can lodge a TPD claim while you have WorkCover on foot.

We recommend waiting until you have good medical material in support of your ongoing capacity to work obtained by the WorkCover claim so you can use this material to assist your TPD claim.

Finally, you should keep in mind that a TPD claim can possibly have an impact on a WorkCover claim. Firstly, in terms of the payment of weekly payments, and secondly in terms of providing WorkCover or their insurer with material that may be used to oppose your WorkCover claim.