What a Diagnosis Alone Can't Tell You
What tasks you can and can't perform, how consistently you can work, and what happens when you attempt to.
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Your guide
Plain-English Information
Plain-English information, reviewed by the Thrive Claims team. This guide explains how TPD claims are assessed, what insurers actually look at, and the circumstances that may be relevant to your own situation.
Work capacity is often an important part of a TPD claim. The relevant question isn't always simply whether you're currently working, it's what your condition means in practical, day-to-day terms.
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Call1300 059 888What Is Work Capacity Evidence?
Information that helps explain how an illness or injury affects a person's ability to perform work.
- Duties
- Hours
- Attendance
- Physical capacity
- Cognitive capacity
- Concentration
- Reliability
- Workplace adjustments
- Restrictions
- Employment history
- Failed return-to-work attempts
Why Does Work Capacity Matter in a TPD Claim?
TPD insurance generally concerns an inability to work or perform work according to the definition contained in the applicable policy — meaning the assessment may need to connect the medical condition to actual functional capacity. A diagnosis alone may not explain what tasks you can or can't perform, how consistently you can work, whether you can sustain employment, or what happens when you actually attempt to.
Can I Claim TPD If I Am Still Working?
Yes, potentially. Working doesn't automatically mean a person cannot make a TPD claim.
- Reduced hours
- Modified duties
- Lower responsibilities
- Increased leave
- Workplace accommodations
- Unsuccessful return to work
- Reduced reliability
What Employment Information Can Be Relevant?
Depending on the claim, relevant employment information may include job title, duties, hours, employment history, changes to duties or hours, workplace adjustments, leave, return-to-work attempts, cessation of employment and previous occupations. The relevance depends on the policy and your circumstances.
Can Workplace Adjustments Affect a TPD Claim?
They can be relevant. Workplace adjustments may show that a person is working under conditions different from those that applied before their illness or injury. Workplace accommodations don't automatically determine whether someone qualifies for TPD.
- Reduced hours
- Lighter duties
- Additional breaks
- Working from home
- Reduced responsibilities
- Removal of tasks
- Assistance from colleagues
What If I Can Do Some Work But Not My Old Job?
This depends on the applicable TPD definition. Some policies focus on the person's own occupation, while others involve broader work-capacity considerations — the policy wording genuinely matters here. See Do I Qualify for a TPD Claim? →
What If I Can Work Another Job?
Being capable of another type of work doesn't automatically answer whether you satisfy a TPD definition. The applicable policy may define the relevant work test differently — this is why your occupation, transferable capacity, medical restrictions and policy wording may all matter together.
What Evidence Can Show Reduced Work Capacity?
Potentially relevant information can include:
01 Medical and specialist reports
02 Employment records and job descriptions
03 Attendance and leave records
04 Workplace adjustment information
05 Work capacity assessments
06 Treatment records
07 Evidence of reduced hours or duties
The relevance of each type of information depends on the claim.
Work Capacity and Mental Health Conditions
Mental health conditions can affect work capacity through concentration, memory, stress tolerance, reliability, attendance, decision-making, social functioning, emotional regulation and ability to sustain workplace demands. See PTSD, Depression, Anxiety and Bipolar Disorder.
Work Capacity and Physical Conditions
Physical conditions can affect lifting, standing, sitting, walking, reaching, repetitive movements, mobility, physical endurance and pain tolerance. See Chronic Back Pain, Fibromyalgia and Arthritis.
Work Capacity and Neurological Conditions
Neurological conditions may affect cognition, memory, coordination, concentration, fatigue, mobility, communication, reliability and physical function. The specific effects depend on the condition and your individual circumstances. See Multiple Sclerosis, Parkinson's Disease and Acquired Brain Injury.
What If I Have Multiple Conditions?
More than one condition can contribute to reduced work capacity — and the overall impact may be genuinely different from considering each diagnosis in isolation. See TPD Claims With Multiple Conditions →
Related claim areas: our services, TPD claims, superannuation claims, income protection claims, multiple super funds claims, mental health claims, physical injury and illness claims, TPD claims for DSP recipients, TPD claims for NDIS participants, TPD claims for motor accident claimants, and TPD insurance through super.
The ability to perform a task once is not necessarily the same as being able to maintain it throughout a working week. Evidence about hours, duties, reliability, attempted returns and restrictions can help explain the practical questions behind a TPD claim. Those questions must be related to the cover involved in superannuation claims, and may differ from the tests used in Income Protection claims. Work limitations caused by physical injury or illness or mental health injury or illness need to be described in concrete terms, not just by diagnosis. Different super fund policies may also assess occupation or capacity differently. If you receive DSP support or participate in the NDIS, your work circumstances may still deserve an insurance review, although those assessments do not replace the policy test. The same practical account can matter after a motor vehicle accident affects your ability to work. Through our claims services, Thrive Claims can help you explore which pathway fits the evidence about your working capacity.
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TPD Claims Resources
20 pages of plain English resource library covering evidence, timeframes, payouts and appeals.
Conditions we help with
TPD Claims & Medical Conditions
TPD claims can arise from many different illnesses and injuries. Explore by category below.
Common questions
Frequently Asked Questions
Straight answers about TPD work capacity evidence, written in plain English.
What is TPD work capacity evidence?
It's information that helps explain how an illness or injury affects a person's ability to perform work. Depending on the circumstances, relevant information may include medical evidence, functional limitations, employment information and changes in capacity over time. See TPD Medical Evidence →
What does work capacity mean for a TPD claim?
It generally concerns what a person is able to do in relation to work, rather than simply whether they have a particular diagnosis. How that concept is assessed depends on the wording of the applicable TPD policy and your individual circumstances. See Do I Qualify for a TPD Claim? →
Can I claim TPD if I can still work some hours?
Yes. Working reduced hours does not automatically rule out a TPD claim. Your hours, duties, restrictions, consistency and ability to sustain employment may all be relevant. See Can I Claim TPD While Working? →
Can modified duties affect a TPD claim?
Yes, they can be relevant. Modified or alternative duties may be relevant when considering the effect of an illness or injury on work capacity. What those changes mean for a TPD claim depends on the particular policy and your actual circumstances rather than the job title alone. See TPD After Leaving Work → where work capacity has progressively changed.
Who can provide evidence about my work capacity?
Depending on your circumstances, this evidence may come from treating doctors, specialists and other healthcare professionals, together with relevant employment information. The type and value of evidence differs between claims. See TPD Medical Report →
Is a diagnosis enough to prove TPD?
No, not on its own. A diagnosis can be important, but it doesn't necessarily explain your functional capacity or ability to work. TPD claims often require consideration of how the condition affects your actual functioning and employment circumstances. See TPD Multiple Conditions → where more than one condition may be affecting work capacity.
Can I get a formal work capacity assessment done specifically for my claim?
Yes, some occupational therapists and rehabilitation specialists conduct formal functional or work capacity assessments that can genuinely strengthen a claim by providing objective, structured evidence. These are separate from a standard GP or specialist report and can be worth discussing with your treating team.
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