There are many factors considered by insurance companies when determining whether to accept or reject your TPD claim. Your doctors and other treating health practitioners play a crucial role in the success of your TPD claim. In this blog, we look at our top 5 tips related to working with your doctors towards optimising the success of your TPD claim.
Every TPD claim is different. The differences can be born out of:
- the nature of the injury or illness which is causing you to be unable to work;
- the TPD definition under which your claim is to be assessed; and/or
- which insurer is responsible for assessing your claim and the strength of the support which is provided by your treating doctors.
Our top 5 tips for working with your doctor during your TPD claim
These tips provide guidance on how to work with your doctors to give your TPD claim the best chance of success.
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Create strong relationships with your doctors
The certifications provided by your treating doctors as part of your TPD claim are possibly the single most important part of your claim.
We find that those people that have had a long-standing association with their doctors, or those that have doctors which are empathetic and fully understand your injury or illness, have the best chance of success. A doctor that knows you well and/or knows your condition well is most likely to be supportive of your claim.
Also, making sure that your doctor understands what you do for a living and what exactly is required is super important too.
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Be clear with your doctor regarding symptoms of your injury or illness
In our experience, many people interact with others like this:
Person A: How are you going?
Person B: Yeah, not too bad.
This interaction is perfectly normal and reasonable with friends or a bank teller, but it is not a good way to interact with your doctors. Believe it or not, many people have interactions like this in consultations with their doctors.
So that your doctor fully understands the extent of your illness or injury, it’s important that you disclose to them all of your symptoms and all of the associated limitations. Too often we see TPD claims rejected because our client’s doctor does not fully understand the limitations which the patient faces on a day-to-day basis.
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Discuss ceasing work due to illness or injury with your doctor prior to making the decision
If you cease work due to illness or injury and go on to claim a TPD benefit, your doctor will usually need to certify that you have ceased work due to illness or injury and are permanently unable to work within your education training experience, or similar.
Therefore, to help you have some peace of mind about whether your claim will be successful or not, we recommend that you discuss your doctor’s opinion regarding your capacity for work now and in the future, prior to making your TPD claim.
This prevents you being surprised if your doctor will not support a claim. Also, because agreeing that you are unable to work, your doctor may ask that you undergo tests or attempt to work with restrictions. By having these conversations with the doctor upfront, you are increasing the chances of a successful TPD claim.
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Make sure your doctor takes adequate notes
When discussing your TPD claim and work capacity, now and in the future, with your doctor, we recommend that you encourage your doctor to make notes.
In some cases that we have been involved with, insurers have rejected insurance claims because the doctor’s notes do not record any difficulties with work. In these claims, the insurer has instead decided that the person retired to spend more time with family or to play golf!
Issues like this can usually be overcome with strong medical support, but it would be better to avoid the issue altogether.
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Treatments options
Explore all of the available (and affordable) treatment options that your doctor recommends. If your doctor understands that you have done all you can to get well and get back to work before making the decision to cease work and lodge a TPD claim, they are much more likely to support your claim.
As outlined above, doctors represent an extremely important part of a TPD claim. Making sure that your doctor understands you, your illness or injury and the limitations on your work capacity is very important. Hopefully, the above helps.
Get help from a TPD lawyer
We are highly experienced Super TPD lawyers. Our team has run and won hundreds of successful TPD claims. If you’re having any issues with your TPD claim or you wish to discuss your options prior to stopping work and lodging a claim, we offer:
- Free advice
- No win no fee claims
- No upfront fees
In other words, it costs you nothing to find out where you stand.
Contacting Berrill & Watson
📞 Melbourne: 03 9448 8048
📞 Brisbane: 07 3013 4300
📞 Anywhere else in Australia: 03 9448 8048
How we charge
We are Australia's best-value superannuation/insurance law firm. Other law firms charge nearly double (& sometimes more than double) what we charge. So, if you get a quote from them, or have a cost agreement, ask us what we will charge you.