Total and permanent disability (TPD) insurance provides financial support to anyone who has sustained life-changing illnesses or injuries that cause them to be unable to go back to work. However, in many cases, a person can be deemed to have a total and permanent disability but can later return to work. With new therapies, rehabilitation techniques and medicines, symptoms may be controlled and lessened which would allow a person to either return to their job or retrain in another occupation that is less demanding on them.
How to Interpret TPD and Returning to Work
There are many misconceptions around interpreting the term ‘TPD’ because there are many different insurance companies with different definitions in their policies. Whether someone can return to work after a TPD varies from claim to claim and depends on what their policy definitions state. To find out with absolute certainty whether you can return to work or not after your TPD claim, always check with your lawyer who will know exactly how to interpret your insurance policy. Still, here is a summary of some common grounds where definitions are similar and where a person must:
- Never work again doing their usual or own job or profession
- Never work again in areas of their training, education, and experience
- Have lost the use of their vision or two limbs
- Be unable to carry out their activities of daily living (ADL)
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Activities of Daily Living (ADL)
The definition of ADL varies with every different insurance company and there will be different requirements and wording in their TPD policies. However, the definition of ADL insurance that is commonly required is that you can’t do any two of the following without being helped by another person:
- Moving (walking, standing, getting into bed)
You won’t satisfy the definition of ADL if you can do the above things with, for instance, a walking frame, crutches, or modified toilet. If you do satisfy the definition of ADL, you might be able to go back to work after a TPD claim without it affecting your benefit.
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To be classed as TPD under an ‘own-occupation’ definition, you have to cease work and not be able to return to your own occupation. You would need a doctor or specialist to closely examine your condition and the kind of work you are required to do, plus supply medical evidence showing why you cannot function in your usual job due to your disability. The main point in ‘own-occupation’ is the extent of disability defined in your insurance policy – the definition is flexible. Whether or not you can you work after a TPD payout is something you must check with your lawyer before you make any lifestyle changes that might affect your benefit.
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If you have a permanent disability and you are unable to work at your own job and can’t perform any occupation that is reasonably suitable for you considering your education, training and experience, you may qualify for a TPD benefit under this definition. However, it is not as certain as the ‘own occupation’ definition. It’s been shown by legal precedents that when deciding if you’re ever likely to work again due to a disability, an insurance company can suggest that you may be able to work doing a wider range of jobs. Some of these may be nothing like your previous occupation, but might suit your disability and TPD claim requirements.
Loss of Use of Limbs
Again, the wording and definitions will be different depending on your TPD insurance policy, but generally speaking, the following will apply and require that you have lost, or have lost the use of:
- Both arms; or
- Both legs; or
- One arm and one leg.
You might be able to go back to work after a successful TPD claim without it affecting your claim or claims provided you fall into the above category.
If you have TPD insurance and you’ve been injured or you have an illness that prevents you from working at your usual job, call PK Simpson for advice today to help you interpret your policy so you can make a claim and receive what you are entitled to receive. If you need help with your TPD claim, whether it’s been accepted or rejected, or if your insurance company has kept you waiting too long, get in touch with us. Where ever and however your injury happened, it is always worth talking to PK Simpson lawyers. Call now on 1300 757 467 or email firstname.lastname@example.org.