QSuper wins Federal Court hearing over TPD benefits

The Federal Court has ruled in favour of QSuper regarding non-payment of a total and permanent disablement (TPD) benefit to a member.

In June 2013, the applicant formally terminated his work with Queensland Health after taking stress leave and made a claim under QSuper’s total disability insurance scheme.

He stated adjustment disorder combined with mixed anxiety, depressed moods, major depressive disorder, and post-traumatic stress disorder had left him unable to work. 

However, the QSuper board was not satisfied that the applicant’s condition was “not related to a pre-existing medical condition” and declined to pay the benefit.

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This decision was then taken to the Australian Financial Complaints Authority (AFCA) that also sided with the QSuper board. 

In Federal Court on 20 September, Justice Meagher upheld the decision of AFCA and the QSuper board and ordered the applicant to pay QSuper’s costs. 

He concluded that AFCA had taken a point of law raised by the applicant into consideration when he referred to an ‘ambiguous’ medical report by Professor Alexander McFarlane that he believed was flawed.

This had discussed whether the TPD was caused by the workplace threats and bullying he experienced in his role at Queensland Health.

AFCA had stated that, despite the workplace situation in 2013, the applicant did indeed have a pre-existing medical condition as there was a “key single common element in each diagnosed condition present in the applicant’s medical history” between 1996 and 2009.

The complaints authority also considered a second medical report obtained by the applicant but found it “added little weight” to the AFCA decision.

Justice Meagher said: “Despite the applicant’s complaint that the report is flawed, the Authority found that it answered the questions that were asked of it, and that Professor McFarlane accurately identified the relationship between the applicant’s pre-existing medical condition and the condition that led to him becoming TPD.

“I am satisfied that the applicant has raised a question of law. Insofar as it was required to do so, I am satisfied that the Authority resolved any ambiguities in the report of Professor McFarlane – just not in the manner contended for by the applicant.”

Earlier this week, Super Review discussed how AFCA is seeing a rise in super complaints as members skip past super funds’ internal dispute resolutions in favour of contacting AFCA directly.