Whether you have become an amputee due to an injury or an illness, if you’re unable to work as a result of that amputation, you may have a right to claim TPD or income protection benefits, which you hold in your superannuation account or you have purchased directly from an insurer.
This is because being entitled to a TPD or income protection benefit usually requires that you either permanently or temporarily cease work, and most amputations impact your capacity to work, at least temporarily.
Also, under some insurance policies (whether inside or outside super), an amputation in and of itself can entitle you to a TPD. This can sometimes be the case even if you continued to be capable of working.
Can amputees be entitled to income protection benefits?
Most people who suffer an amputation, regardless of whether that amputation is caused by an illness such as diabetes, an infection or a motor vehicle or workplace accident, will be entitled to claim on their income protection entitlements.
To be successful with that claim, you will need to prove that the illness or injury that has led to the amputation and/or the amputation itself has prevented you from working. The inability to work can be for a few months or permanent.
If the inability to work is for a few months, you will usually be paid the benefit after the end of the waiting period, for as long as you are not able to work due to your illness or injury and recovery.
If the inability to work is permanent, you will usually be paid benefits for your full income protection benefit period, which might be 2 years, 5 years or until age 60, 65 or 70 years of age (it depends on the relevant policy terms).
You will usually prove your work incapacity by getting reports completed by your doctors about your illness and, in most cases, you will be paid income protection benefits for as long as your doctor say you are unable to work.
Depending on your policy terms, it may be enough that the amputation prevents you from doing one important income-producing duty of your usual occupation.
For example, if you work in a role that requires you to do mostly administrative duties, but also some deliveries of goods, and your amputation means that you are no longer able to make deliveries, this will usually be enough to entitle you to income protection benefits under some policies.
In other cases, you may need your doctors to help you prove that you can’t do your own duties or jobs that are within your education, training or experience.
After an initial period of recovery and rehabilitation, some people may be able to return to work after an amputation. If this happens, but you are not able to do all of the duties of your occupation, or you are unable to work as many hours as you used to work (or both), and you get less income, you may be able to claim your income protection payments as a partial benefit. This will entitle you to a top-up payment of income protection benefits on top of the income you earn from working.
No matter what the cause of your amputation or the work that you did, most people who suffer an amputation will be entitled to claim income protection benefits and should consider a claim to financially support them through the life-changing impact of the amputation.
If you’re unsure if your disability insurance (either inside or outside super) covers you for income protection, we can help you find out for free. Likewise, if you have any issues with your claim or your income protection claim is rejected, we can offer you free initial advice about your options.
Can amputees claim TPD benefits?
If you suffer an amputation due to an illness or injury, you may also be entitled to a TPD benefit. Under most policies, the TPD benefit can be paid on top of your entitlement to income protection benefits. You can read more about this in our earlier blog, “Can I claim TPD and income protection benefits at the same time?”
To be paid a TPD benefit due to amputation, you must usually satisfy the relevant TPD definition. The TPD definition is different under different policies, and there may be more than one TPD definition within the one insurance policy.
If you are prevented from returning to your old work or work that you are reasonably able to do based on your previous work history, training or education, due to you amputation and/or the associated illness or injury (including subsequent mental illness due to the injury or illness), you will usually be entitled to a TPD benefit.
Loss of limbs definitions in TPD policies
Also, most insurance policies will define TPD not simply in connection to work, but the policy may also include a “loss of limbs” TPD definition.
The loss of limbs definition is usually harder to satisfy than the work-based definition, but under some insurance policies, an amputee may be entitled to a TPD benefit even if they are able to work (with or without restriction). This varies from policy to policy, and some policies that include a “loss of limbs” definition require the loss of more than one limb to qualify, or they also require that, in addition to the loss of limbs, you also be unable to work.
Policies vary and advice should be sought about a possible TPD claim if you have suffered an amputation or the loss of use of one or more limbs.
Get help from a disability insurance lawyer
If you have suffered an amputation, you should get some advice about making a possible claim on your income protection or TPD insurance entitlements. The benefits payable can give you much-needed financial support during a period of financial and physical adjustment. We give free advice to amputees about possible claims for insurance benefits.
Get in touch with a member of our team for some free initial advice.
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