Practical, general tips for GPs handling these requests — not official, legal or insurance advice, and not a substitute for the insurer's own form or your own professional judgement on a particular case. These are private commercial products, not a government scheme — there's no standard national form, and you're not the one who decides whether the claim succeeds. Here's what you're actually being asked for, what to charge, and a copyable structure for the factual part of your response.
TPD (Total and Permanent Disability) pays a one-off lump sum if illness or injury leaves someone permanently unable to work. It can be held inside superannuation (cheaper, but a payout may be taxed up to 22% if the patient is under 60) or outside super (more expensive, but usually the only way to get the more generous "own occupation" definition).
Can't work in their previous specific job. More generous to the patient, more expensive, usually only available outside super.
Can't work in any job "suited to their education, training or experience" — not just their old one. Cheaper, stricter to satisfy.
Can't independently perform basic self-care tasks. The highest bar of the three.
Income protection is different in shape: it replaces an ongoing 75–90% of pre-tax income (based on the prior 12 months' earnings) rather than paying a lump sum, after a waiting period (commonly 14 days to 2 years) and for a benefit period (commonly 2 or 5 years, or to a set age such as 65). Each policy sets its own definition of "disabled" for this purpose — there is no single Australia-wide standard.
General pointers only — every insurer's questions differ, so read the actual form before you start.
If a form's question is really asking you to apply the policy's own definition of "total and permanent" or "any occupation" — a legal/contractual test, not a clinical one — it's reasonable to answer the clinical part of the question and note that the ultimate determination is a matter for the insurer based on the policy wording, rather than guessing at how your clinical answer maps onto contract language you haven't seen.
There's no Medicare item for completing an insurance report — it's not a service for the treatment of a patient, so it's billed privately, and GST generally applies. The RACGP's guide suggests basing the fee on your usual per-hour consultation income applied to the time the report actually takes, rather than a flat fee that doesn't reflect a complex, multi-page request. Tell the patient (or their solicitor/adviser, if they're the one asking) the fee upfront, since it isn't something the insurer pays.
A suggested skeleton to organise a response around — a drafting aid, not clinical content and not an official template. Fill in only what you can support from your own assessment and records, and always follow the specific insurer's own form/questions over this structure where they differ.
No — a completely separate system. TPD and income protection are private commercial insurance products (often held inside super), assessed by an insurer against that policy's own definitions. The Disability Support Pension is a Centrelink payment with its own government forms (the SA478 Medical Evidence Checklist) and a Centrelink-arranged Job Capacity Assessment. See Centrelink Medical Certificates & Reports for that side — a patient dealing with a serious illness may genuinely be pursuing both at once, and they're independent processes with independent paperwork.
No. Your report should reflect your own clinical assessment and records, not a conclusion someone else has already reached. It's reasonable to explain to the patient that whether their situation meets the policy's definition is the insurer's determination, based on the whole file including your factual report — not something you're being asked to pre-confirm.
Generally yes, if one is provided — insurers design their forms around their own policy wording and claims process, and using it avoids a back-and-forth for missing information. The structure above is for organising your thinking and drafting, not a replacement for the insurer's specific questions.
That's a fair position to take, and consistent with limiting your opinion to your scope of expertise — a GP can speak to functional limitations from a clinical standpoint, but assessing them against a specific patient's full work history and the labour market is often outside what a treating doctor can reasonably certify. Some claims involve a separate independent occupational/vocational assessment for exactly this reason; noting that this question is outside your assessment is a legitimate answer, not an unhelpful one.