The level of impairment you need to get a TPD benefit is calculated differently to many other types of injury or illness related benefits or compensation. To be entitled to some benefits under a worker’s compensation scheme a person must show that they have a minimum level of impairment under relevant guidelines (for example the AMA guidelines to the evaluations of permanent impairment).
For other benefits, or to claim a Common Law benefits, a person must apply for and be granted a Serious Injury certificate.
Many people base their potential TPD entitlement on whether or not they're entitled to a Disability Support Pension (‘DSP’) or workers' compensation benefits. They think that because they are not entitled to a DSP or workers' compensation benefits, they will not be paid a TPD benefit. This is incorrect.
The Disability Support Pension benefit assessment is not the same as for a TPD claim
To be entitled to a Disability Support Pension a person must show that they have a greater than 20-point impairment under one or more of the impairment tables (also known as the Social Security (Tables for the Assessment of Work-Related for Disability Support Pension).
There are 15 Centrelink impairment tables. Each table focuses on a different area of functioning.
Some of the areas of functioning which are covered by the tables are ear functioning, intellectual functioning, brain function and spinal function. Each table sets out activities or tasks that a person must be limited or unable to do in order to be awarded a level of impairment under the tables.
For example, to be awarded 20 points under the spinal function table, a person must show that they have an inability to do any one of the following:
- Any overhead activities;
- Turn the head or bend the neck without having to move the trunk;
- Bend forward to pick up a light object from a desk or table; or
- Sit for more than 10 minutes.
As you can see, the requirements to be awarded 20 points under one table are quite specific and very onerous.
Claiming TPD benefits is usually not as difficult as the DSP
Claiming a TPD or Total and Permanent Disability is usually not as difficult as claiming a Disability Support Pension or being awarded a workers compensation Serious Injury certificate.
TPD means different things under different insurance policies. Whilst some TPD definitions do require a minimum level of impairment, this is the exception to the general rule.
Usually, TPD requires that an individual cease work due to illness or injury and be permanently unable to work because of that illness or injury. Therefore, the impact of the illness or injury on a person’s capacity to work is key and no consideration needs to be given to a person’s impairment rating or their capacity to perform different tasks.
An injured person’s ‘work capacity’ is key to claiming TPD
What is required is consideration of a person’s current work capacity; if they can do their usual job and what other work is available within their education, training and experience (or in some cases, after retraining).
This is not to say that a person’s capacity to do overhead activities or bend forward is not a relevant consideration when assessing a TPD claim (it will be if it is relevant to a person’s ability to do their job), it is just not a requirement to claim.
Furthermore, the only requirement for claiming a TPD benefit is that a person stops working and they have a permanent inability to work due to illness or injury, no matter what the cause.
If you have applied for a Disability Support Pension or workers compensation entitlements and your claim has been rejected, don’t think that it’s not worthwhile claiming a TPD benefit. The tests are very different, and it is always worthwhile lodging a claim.