Total and Permanent Incapacity (TPI)
Assessing long-term work capacity in complex disability matters
For more than 18 years, LexiMed has delivered Total and Permanent Incapacity assessments for legal and insurance professionals managing complex disability claims. These assessments focus on long-term work capacity, permanence and how a claimant’s condition aligns with the relevant policy definition.
Understanding Total and Permanent Incapacity
A Total and Permanent Incapacity assessment examines whether an individual is permanently unable to work due to injury or illness. These assessments are most commonly required in superannuation and insurance matters, where entitlement depends on meeting a defined threshold of incapacity.
In practice, TPI matters are rarely one-size-fits-all. Beyond diagnosis, the assessment looks at how a condition affects a person’s ability to work in real terms, both now and into the future. The role of the assessment is to examine that impact carefully and explain it in a way that aligns with policy wording and decision-making requirements.
When are TPI assessments required?
Total and Permanent Incapacity assessments are commonly requested when:
- A claimant cannot return to their usual occupation
- Capacity for any suitable employment is in question
- A superannuation or insurance claim depends on a medical assessment against policy definitions
- The permanence of a condition needs to be established
- A matter has reached a point where long-term outcomes must be assessed
In many cases, a TPI assessment helps bring direction to matters that have been unresolved for some time.
What the assessment covers?
While every matter is different, a Total and Permanent Incapacity assessment typically involves consideration of:
- Medical condition and prognosis: Review of diagnosis, treatment history and long-term outlook, including whether further improvement is expected
- Functional capacity: Assessment of physical and psychological ability to perform daily activities and work-related tasks
- Work and vocational background: Consideration of education, training and work history, alongside the practical demands of potential alternative roles
- Policy definition: Examination of work capacity against the applicable policy wording, including distinctions such as “own occupation” or “any occupation”
- Permanence: Evaluation of whether the condition is ongoing and unlikely to improve to a level that would allow gainful employment
The focus is not on theoretical roles, but on realistic work capacity in light of the claimant’s background and condition.
Specialist input matched to complex disability matters
LexiMed works with more than 20 experienced medicolegal specialists across a wide range of disciplines. This allows each TPI matter to be assessed by a specialist with experience relevant to the condition and issues being examined.
Our network includes, but is not limited to, orthopaedic surgeons, psychiatrists, neurologists, occupational physicians, rehabilitation specialists and other relevant practitioners. Each specialist is selected for their clinical expertise and their experience assessing long-term incapacity in a medicolegal setting.
This range of specialist coverage allows us to manage matters involving physical injury, psychological conditions, chronic illness or a combination of factors.
What to expect when you partner with LexiMed
Balanced medical opinion
TPI assessments require careful judgement. Our specialists take a measured approach, forming opinions based on medical findings, functional impact and experience.
Policy-aware reporting
Work capacity is assessed in the context of the relevant policy definition. Reports address these criteria directly, reducing uncertainty and follow-up queries.
Considered assessments for claimants
Assessments are conducted professionally and without unnecessary pressure. Specialists take the time to understand medical history and vocational background, which is critical in long-term incapacity matters.
Experience that informs every assessment
With more than 18 years of experience working in the medicolegal space, we have seen what works and what does not. That experience guides how specialists are selected, how assessments are arranged and how reports are prepared, helping avoid common issues that can slow a matter down.
Timely reporting that keeps matters progressing
We understand how delays can affect the momentum of a matter. Our reporting process is designed to move efficiently from assessment to delivery, so medical opinion is available when it is needed, not weeks later when timelines start to slip.
Reports prepared locally and with care
All reports are prepared by our Australian-based team. Nothing is sent offshore, meaning we have closer collaboration with our specialists, careful handling of information and a level of attention that comes from working within the same time zone and professional environment.
Our process
STEP 1
Make an appointment
Contact LexiMed to discuss the matter. Our team will help identify the most suitable specialist and arrange the assessment.
STEP 2
Examination and assessment
The claimant attends the examination with the nominated specialist. Depending on the matter, the assessment may focus on a single condition or multiple injuries.
STEP 3
Reporting
The specialist prepares a structured medicolegal report addressing long-term work capacity, permanence and policy considerations.
Based in Brisbane, operating nationwide
Our network of medicolegal specialists and medical suites extends across Australia, making it easy to arrange assessments wherever they are needed.
When a claim turns on permanence, arrange a TPI assessment
Speak with our team to arrange a TPI assessment aligned with the policy, work capacity issues and long-term considerations.