Your TPD only Lawyers

NAME: TPD Benefit amount: $76,800 First name of the client: Jed Injury/illness: Psychological Injury

CLAIM Jed contacted WKB Lawyers to assist with his TPD claim, as the process he felt was a bit overwhelming. We contacted all his treating Doctors and obtained all relevant information to run his claim for him. We completed all relevant forms and he signed them. We lodged the claim with the fund, but the claims assessor wanted to arrange an IME because of irrelevant comments made in a Workcover claim. We argued that this was unnecessary and that all relevant information and evidence has been supplied. Jed’s claim was approved three weeks after submitting a complaint response to the fund’s IME request.

NAME: TPD Benefit amount: $500,000.00 First name of client: Mohammad Injury/illness: Micro-sleeping & Sleep Apnoea

CLAIM Mohammad contacted WKB Lawyers to run his TPD claim as he had a retail policy as well as a default cover policy. We arranged all relevant evidence to be collected and submitted the claim promptly. The fund attempted to claim that our client had a non-disclosed pre-existing condition of mental health. We were able to successfully argue that there was no such pre-existing condition and that the incident they were referring to was completely situational and resolved very quickly. Mohammad’s claim was then promptly approved a few short weeks later.

NAME: TPD Benefit amount: $1,791,784.05 First name of client: Nicholas Injury/illness: 5 back fusions

CLAIM In 2014, Nick had his first back fusion, a further fusion in 2018 in Hong Kong. Unfortunately, the fusion was not successful, Nick and his wife flew back to Australia for further surgery. The TPD claim was submitted with the IPI claim in late 2019. In April 2020 a further two surgeries were performed.In June 2020, the insurer issued a procedural fairness. The client continued with insurer, stating that he was unable to complete his duties under his ‘own occupation,’ In October 2020, further surgery preformed due to failure of previous surgery, the claim was further declined. WKB Lawyers came on board, and while a further 3 months passed with writing submissions and providing evidence. It took, writing an executive complaint to point out the facts of the case and the reasons why the client is unable to continue under his own occupation policy. The claim was overturned and paid and now we have an interest claim has been lodged with AFCA, as the claim should have been paid in October 2020.

NAME: TPD Benefit amount: $154,000 First name of client: Fiona Injury/illness: Mental Health, depression, anxiety.

CLAIM Fiona submitted her claim with SunSuper. When her claim was declined due to not meeting the ANY occupation definition, she requested WKB Lawyers to review the decision. On receipt of reviewing the procedural fairness it was determined that and independent medical review by a physiatrist was required. We summarise the claim for the psychiatrist and provide all the medical reports and request the doctor to answer very specific questions which takes into account the definition, the facts of the matter. A re submission to the insurer was provided with the material evidence. The claim decision was overturned within 6 weeks.

NAME: TPD Benefit amount: $2,500,000.00 First name of client: Ian Injury/illness: Mental Health

CLAIM In 2018, Ian ceased work due to his Mental health. The TPD claim was submitted by Ian in June 2019, accompanied by treating doctor reports from his specialist. In September 2020, the insurer issued a procedural fairness. This letter stated that our client had a high likely hood of returning to work within his education, training and experience. WKB Lawyers were instructed to review the claim to see if our client has prospects of having his TPD claim overturned. After reviewing all the evidence, it was found that there were some evidentiary gaps in the medical evidence. Therefore, WKB Lawyers were instructed to take over the claim with a nice, fixed fee cost agreement. WKB lawyers then proceeded with technical submissions including the use of some decided case law in support that our client was TPD. We were very proud to contact the client and let him know that his TPD claim was overturned and paid in January 2021

NAME: TPD Benefit amount: $2,216,000.00 First name of the client: Des Injury/illness: Mental Health, Knee and Shoulder

CLAIM In 2020, Des ceased work due to his Mental health, Knee and Shoulder issues. Our client decided to have a Lawyer lodge the claim on his behalf to take the stress away and to make sure his claim was guided to a successful conclusion. The client contacted several firms and after a meeting with Warren, decided to go with WKB Lawyers because of their experience and well fixed fee. After gathering the medical evidence necessary, The TPD claim was submitted by WKB Lawyers on 4 September 2020, accompanied by treating doctor reports from his specialist, medical evidence from CSC and the claim forms along with the support of some strong submissions. Unfortunately, the Insurer had made some errors in the initial assessment by requesting irrelevant reports and after 5 months, WKB Lawyers made a complaint that the claims assessor did not have the skills necessary to assess the claim. Our client’s claim was then past onto another “more senior” case assessor. The claim was then assessed as to whether our client provided full and frank disclosure. Overall, the Insurer took a very tough and tortured approach to our client’s TPD claim. After complaints to the executive team and more technical submissions including the use of some decided case law in support that our client was TPD. We were very proud to contact the client and let him know that his TPD claim was approved for the full amount and paid in September 2021.

NAME: TPD Benefit amount: $105,118.24, First name of the client: Trevor Injury/illness: Cervical Spine injury, Lumbar spine

CLAIM Trevor had been working in the construction industry where his duties entailed lifting heavy bags of render, heavy physical labour and operating a hoist. Unfortunately, due to a workplace injury moving 14 bags of render 3 times, our client noticed immediate lower back pain that developed which radiated through his neck and left arm. In mid-2021, Trevor reached out to WKB Lawyers to run both his TPD claims with CBUS and BUSSQ. We quickly collected all of Trevor’s existing reports from his Workcover claim and requested Medical Attendant Statements from two of Trevor’s primary treating Doctors. We were able to lodge the claims quickly with both funds. Our client was also in financial hardship so WKB acted quickly, and also lodged a Permanent incapacity claim with the trustee for CBUS, which took less than a week to be approved. Shortly after, both TPD claims were approved.

NAME: TPD Benefit amount: $130,742.89 First name of client: Christopher Injury/illness: Back injury – Lumbar, Shoulder injury – Left Shoulder, Mental Health

CLAIM Chris had initially injured himself 1996, when he was working to lift engines from cars and found that after 3 months, our clients back was starting to hurt and cause issues, after 6 months he started seeing his doctor as it was impacting his capacity to work. Unfortunately, our client was diagnosed with spondylolisthesis. Chris attempted to use consistent pain relief and exercises to try and extend his work life. In 2008, Chris had a spinal fusion which did give some relief for a few years, however, the surgery noted severe degenerative lumbar disc disease. In 2017, his injuries escalated, and he was offered light duties but was unable to use his left arm and consistent chronic back pain. Chris was referred to WKB Lawyers in April 2021, and we quickly worked with Chris to obtain all relevant medical evidence. WKB Lawyers then promptly submitted the claim in mid-July. Within in a month, we had obtained a successful outcome, by taking the time collect and corroborate all evidence for the fund prior to submission.

NAME: TPD Benefit amount: $348,000.00 First name of client: Susan Injury/illness: Major depressive disorder, adjustment disorder and respiratory reaction from inhalation of chemical.

CLAIM In 2019 Susan ceased working due to a decline in her mental health following workplace incident, she unfortunately could not return to the work she was educated, trained, or had experience in. WKB invested the time to ensure that we were able to obtain all the required evidence to lodge a successful claim. We drafted a detailed submission and after a short 8 weeks the claim was formally approved.

NAME: TPD Benefit amount: $617,985.00 First name of client: David Injury/illness: Parkinson’s Disease

CLAIM In 2017 David was diagnosed with Parkinson’s Disease. He continued to work up until July 2021. David contacted WKB to assist with his TPD Claim, while we were waiting for the Waiting Period to lapse, we were obtaining the required medical evidence. We were able to lodge his claim with all the relevant medical evidence in September 2021 and a decision was made within 7 weeks.