What is Total and Permanent Disablement?

QSuper’s Total and Permanent Disability (TPD) cover pays a lump sum to you if you meet the definition of total and permanent disablement. Generally speaking, for most working people a total and permanent disablement means you’re unable to ever work again in a job given your education, training or experience.

However the actual definition may differ depending on your personal circumstances and we’ve explained this further in the following paragraphs.

“Total and permanent disablement” means that in the opinion of the insurer, you:

  • are under the care and following the advice of a medical practitioner, and meet one of the following definitions in Parts A, B or C as applicable, and
  • meet, in the insurer’s opinion, the “Permanent Incapacity” definition contained in the Superannuation Industry (Supervision) Regulations, as amended from time to time.

Where at the Date of Disablement, you were:

  • gainfully employed or unemployed for less than six months, Part A applies
  • not gainfully employed and unemployed for more than six months, Part B applies, or
  • not gainfully employed and unemployed for more than six months and performing home duties, Part C applies.

“Gainfully employed” means being employed either as an employee or self-employed person for financial gain or reward.

Part A - Standard definition

Where at the date of disablement you were gainfully employed or unemployed for less than six months, total and permanent disablement means solely because of an injury or illness, you’ve been absent from work and in the opinion of the insurer, after obtaining the advice of not fewer than two medical practitioners, which the insurer may require to be a specialist in the condition or related conditions, you’re unlikely ever to be able to work again in a job for which you’re reasonably qualified by education, training or experience that you’ve acquired or could reasonably be expected to be able to acquire in the future within a suitable rehabilitation/ retraining program.

In determining what could be acquired in the future, the insurer will consider if the injury or illness prevents you from being able to undertake retraining or rehabilitation to acquire education, training or experience.

Part B - Activities of daily working

Total and permanent disablement means that solely because of injury or illness, in the opinion of the insurer, after obtaining the advice of not fewer than two medical practitioners, which the insurer may require to be a specialist in the condition or related conditions, and after considering all medical evidence, you’re continuously unable to perform (with aids and adaptations) at least three of the following activities of daily working:

  • Rising/sitting: the ability to rise and sit using a chair with arms without the help of another person.
  • Hearing: the ability to clearly hear (with a hearing aid or other aid if normally used) conversational speech in a quiet room in your first language.
  • Communicating through speech: the ability to speak with sufficient clarity to be able to hold a conversation in a quiet room in your first language.
  • Seeing: decreased visual ability such that, even when tested with visual aids, vision is measured at 60/60 or worse in the better eye using a Snellen chart.
  • Walking: the ability to walk more than 200 metres on a level surface without stopping due to breathlessness, angina or severe pain elsewhere in the body.
  • Lifting and carrying: the ability to lift (from bench height) and carry a 2kg weight a distance of 10 metres and place the item back down at bench height.
  • Communicating through written words: the ability to write legibly with a pen or pencil or use a keyboard with either hand.

Part C - Home duties

Total and permanent disablement means that you:

  • are under the regular care of a medical practitioner in relation to the relevant injury or illness,
  • are unable to perform home duties,
  • are unable to leave your home unaided,
  • from the date of disablement, have not engaged in any employment for a period of three consecutive months after the occurrence of the injury or illness, and
  • at the end of the three months, in the insurer’s opinion after consideration of all relevant evidence, and after obtaining the advice of not fewer than two medical practitioners, of which the insurer may require one or more to be a specialist in the condition or related conditions, are disabled to such an extent as to render you unlikely ever to perform home duties or engage in any gainful occupation.

It’s important to note, though, that while death cover and total and permanent disability (TPD) cover are provided separately you cannot claim both – your death cover will be cancelled if you receive a TPD benefit.

The only time you’ll keep death cover is if your death cover is greater than the TPD benefit that is paid, in which case you’ll keep the difference. See Sierra’s story below to see how this works. Similarly, if you receive a death benefit due to a terminal illness claim, you’ll only keep the TPD cover that is greater than the death benefit paid.

Case Study

Sarah

Sierra is 45 and has fixed TPD cover worth $400,000 and fixed death cover worth $550,000. After a car accident she is assessed and deemed to be totally and permanently disabled, and receives a TPD benefit of $400,000. The first $400,000 of her death cover is cancelled, but she keeps the remaining $150,000 of death cover.

Please note that the case studies are provided for illustrative purposes only and the members shown aren’t real. It is assumed for the purpose of the case studies that all terms and conditions have been met. Additionally, figures may be rounded up for ease of understanding.

Please note that in addition to any pre-existing conditions, pre-existing exclusion periods and other exclusions applicable, there are other times when a benefit may not be payable. Please refer to the Accumulation Account Insurance Guide for further details.

Learn more about QSuper's TPD cover.

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