SES TPD claims require careful identification of the insurance involved. Volunteer service, paid employment and any separate volunteer or accident arrangements should not be treated as interchangeable sources of cover.
If illness or injury has affected your ability to work, check any TPD insurance held through your superannuation, paid employment or a separate personal policy. TPD cover can be held inside or outside superannuation.
Volunteering does not establish super insurance
A person may volunteer with the SES while working in a completely different paid occupation. The applicable TPD policy may assess whether the person can work again in an occupation suited to their education, training or experience, rather than simply whether they can continue performing SES duties. Other policy definitions can also apply.
Volunteer-related cover should be identified separately. In Queensland, the Workers’ Compensation and Rehabilitation Act 2003 expressly includes State Emergency Service volunteers among persons who may be entitled to compensation. That is separate from determining whether the person holds TPD insurance.
Set out both parts of your work history
Explain your paid employment, qualifications and relevant SES or emergency service duties. Record when your health began affecting each activity and whether you reduced your hours, changed duties or stopped working.
Being able to perform some limited activities does not, by itself, determine whether you meet a TPD definition. Similarly, being unable to perform a particular SES or rescue task does not necessarily establish total and permanent disability. The applicable policy definition determines what needs to be proved.
Medical evidence and cover dates
Medical evidence should address your condition and the limitations relevant to the applicable policy definition. Depending on the policy, eligibility may also be affected by matters including employment status and whether the relevant cover was in place.
If your circumstances involve a gradual condition, changes in employment or several periods away from work, prepare a clear timeline. Ask your fund or insurer for your insurance history rather than relying only on your latest superannuation statement.
Discuss the possible claim
KSC Law can help distinguish the different policies and identify the requirements that need evidence. Bring your superannuation statements, any volunteer insurance information and existing medical or claim correspondence.
Book a free consultation about TPD claims for emergency services workers. We can first identify which cover needs investigation so you know what documents and evidence are relevant to your potential claim.
Related reading: TPD claims lawyers · Do I qualify for a TPD claim
Further reading
Moneysmart: how TPD insurance works · Australian Financial Complaints Authority (AFCA)