“Shouldn’t I get a TPD payout if I’m injured and can’t work anymore?” – Which case won?
Man suffers serious back injury shovelling earth at work
The complainant was a 61-year-old man who had obtained a higher school certificate and a TAFE certification in grounds, gardening and pool maintenance. He also had training in the hospitality, bar and bistro and security industries.
On 1 September 2000, the man commenced employment as a groundskeeper with the employer. He became a member of the employer’s superannuation fund.
On 20 March 2001 he suffered a back injury at work while shovelling earth into the back of a tipper truck.
He attempted to work following the injury, but due to intense pain was ultimately unable to do so.
The man sought treatment from a chiropractor and underwent a structured exercise program, but the pain continued.
On 16 October 2001, the employer terminated the man’s employment. He received workers compensation after this because of the seriousness of his injury.
The man subsequently tried to work in other capacities, but his pain was too intense to allow him to do this.
Insurer denies TPD claim and injured worker lodges complaint
In late 2012, the injured worker lodged a claim for total and permanent disability (TPD) with the insurer under his employer’s superannuation fund.
The fund’s policy covered the man for total and permanent disability if he was incapacitated to such an extent that he was unable ever to do work for which he was reasonably qualified by his education, training, or experience.
The insurer denied the man’s claim, concluding that he was not totally and permanently disabled.
The man lodged a complaint with the Superannuation Complaints Tribunal, arguing that the insurer’s decision was unreasonable and should be overturned.
It was up to the tribunal to decide if the insurer’s decision should stand.