Questions Frequently Asked by Employees

Do I have to live in New Jersey to receive temporary disability benefits?
No.  Where you live has no bearing on whether you can receive disability benefits.  The most important eligibility  requirement is that you worked for a New Jersey covered employer.

Where can I get a claim form?
You can obtain a claim form (DS-1) directly through this website.  Get an Application.   Or, contact the Division of Temporary Disability Insurance, PO Box 387, Trenton, New Jersey 08625-0387, (609) 292-7060.  You can also request a claim form from your employer, or union.

Is there a time limit for filing a disability claim?
Yes.  You have 30 days from the first day of disability in which to file your claim.  If your claim is received more than 30 days from the start of the disability, you must show good cause why the claim was not filed timely.  You can attach a statement to the claim form (DS-1) explaining why your claim is late.  If good cause is not shown, benefits may be reduced or denied.

I know the date of my surgery, can I file a disability claim (DS-1) before I stop working?
No.  A disability claim should not be filed until your period of disability begins.  Even though you may have a scheduled date for surgery, a claim must not be submitted until you become disabled.

How often do I need to see my physician in order to receive disability benefits?
There is no set requirement as to how often you must see your physician.  However, to continue receiving benefits you must be under the continued care of your doctor.  Periodically,  forms will be mailed to you to obtain updated medical information.  Those forms must be completed by you and your physician and returned to this Division.

What will I receive in temporary disability benefits per week?  How is my maximum benefit amount computed?
For detailed information on benefit calculations, see our web page entitled,  Benefit Calculations.

When do my benefits begin?
Benefits are payable on the eighth consecutive day of your disability.  The first seven days of disability are called the waiting week.  If your disability continues for three consecutive weeks, you will receive benefits for the waiting week.

I returned to work (or) recovered from my disability.  What should I do?
If you have in your possession Form P30, "Request to Claimant for Continued Claim Information, indicate the date you recovered or returned to work, and mail the completed form to this office, immediately.  Or, call this office immediately at (609) 292-7060 to report your recovery or return to work date.

I lost/did not receive Form C10, "Request to Claimant for Disability Information"; M10, "Request for Medical Information"; P30, "Request to Claimant for Continued Claim Information"; or D10/D30, "Notice of Eligible/Ineligible Determination."  How do I get another form?

Call this office at (609) 292-7060 to request the lost or missing form.  We will regenerate the form through our computer system and send it out to you immediately.

My address changed, or the address you have on record is incorrect.  How do I get it corrected?
You must notify us in writing of a new or corrected address.  Be sure your letter includes your full name, complete address, and Social Security number.  We cannot identify your claim without the Social Security number.  Send your letter to Division of Temporary Disability Insurance, PO Box 387, Trenton, NJ  08625-0387.

Can I have more than one (1) disability claim during a year?
Yes.  You can have multiple disability claims during the year.  You must meet the eligibility requirements and have medical documentation for each new claim.

How long does it take to get a decision after a claim is filed?
Provided no additional information is needed, it generally takes about 14 days to receive a decision after your claim is received in Trenton.  However, if your claim does not contain all the required information, it will take longer to process.  That is why it is important to have your employer and your physician complete their portions of the form if at all possible before mailing it to us.

I was collecting unemployment benefits and then became disabled.  Can I file a claim for temporary disability benefits?
Yes.  If you are collecting unemployment benefits and become disabled, notify the Division of Unemployment Insurance, immediately.  File a claim forDisability During Unemployment.  You can obtain a claim form (DS-1) directly through this website, or contact the Division of Temporary Disability Insurance, PO Box 387, Trenton, New Jersey 08625-0387, (609) 292-7060 directly.

Can I collect temporary disability benefits if I was injured on the job?
Work-related injuries or illnesses are not compensable under the Temporary Disability Benefits Law.  However, if you file a claim for workers' compensation benefits and it is contested by the workers' compensation insurance carrier, you may be eligible for temporary disability benefits while the workers' compensation issues are being resolved.  To protect our subrogation rights, we would file a lien against any subsequent workers' compensation award.  For additional information, see our web page entitled Work Related Disabilities.

Can I collect disability benefits while involved in a labor dispute?
If your disability begins on or after the start of the labor dispute in which you are a participant, disability benefits will not be paid for the duration of the dispute.  If you are still disabled after the labor dispute is over, benefits can be paid for the period following the ending date of the labor dispute.

Can I collect disability benefits for alcoholism and alcohol-related disabilities?
Yes.  If you are disabled due to alcoholism or alcohol-related illnesses, you may collect disability benefits as long as you are under the care of a licensed medical practitioner and meet all other eligibility requirements.

Can I collect disability benefits for a drug problem?
Yes.  As long as you are no longer using illegal drugs and you are being treated for the substance abuse in a program with a licensed physician, you may collect disability benefits.  Your physician must certify that you are disabled, and you must meet all other eligibility requirements.

I exhausted my disability benefits under my employer's approved Private Plan, but I am still disabled.  Can I now collect State Plan benefits?
No. Coverage under an approved Private Plan replaces State Plan coverage.  Since you are not covered by the State Plan, you cannot be paid State Plan benefits, even if you continued to be disabled.  Contact your local Social Security office to inquire about Social Security Disability benefits.

I received a notice to report to a doctor for an impartial medical examination.  Am I required to go even though I have my own doctor?
Yes.  During your period of disability you may be required to go to a doctor for an independent medical examination.  Failure to keep the appointment could result in your disability benefits being discontinued.  For more information see our web page entitled Independent Medical Examinations.

I disagree with the decision made on my State Plan claim. Can I file an appeal?
Yes.  The determination you received has a written statement explaining your appeal rights.  For further information on appeals, see our web page entitled Appeals.

I am covered by my employer's Private Plan, and I disagree with the decision made on my Private Plan claim.  Can I file an appeal?
Yes.  You may file an appeal with the Private Plan Compliance Section, Claims Review Unit.  For further information see our web page entitled Appeals.

How much does it cost me each year for New Jersey's temporary disability insurance coverage?
See our web page entitled Cost.

Are disability benefits taxable?
Yes.  A portion of disability benefits is considered taxable income for both the Federal Income Tax and FICA (Social Security).  The portion of the benefits payment that is taxable is that portion attributable to the employer's disability contribution.  The worker's share of FICA is deducted from State Plan benefit payments.  The employer is liable for the employer's share of FICA.  Federal income tax is withheld only if requested by the claimant.

What can I do if I know someone is working while collecting disability benefits?
If you know or have reason to suspect that someone is working and collecting disability benefits notify this Division as soon as possible.  Click here to Report Fraud. Or, call our fraud hot-line at (609) 984-4540.

Frequently Asked Questions Pertaining to Pregnancy

Can I collect disability benefits due to pregnancy?
Yes.  Eligibility for temporary disability benefits due to pregnancy is determined in the same manner as for any other disability.  You must meet the wage requirements and your physician must certify that you are disabled.  For more information, see our web page entitled Pregnancy.

When should I file a disability claim due to pregnancy?
When you have stopped working and your doctor certifies that you are disabled, complete the claim form (DS-1) and mail it to this Division.  Do not file the claim before you stop working or before your physician says you are disabled.  If you file the claim while you are still working, or before the doctor certifies that you are disabled, your claim may be denied.

How long can I collect benefits for my pregnancy?
For a normal pregnancy benefits are usually payable for up to four (4) weeks before the expected delivery date and up to six (6) weeks after the actual delivery date.  Benefits may be payable for a longer period if your doctor certifies that  you have a specific complication related to the pregnancy; you have a Caesarean section; or you have another simultaneous disability.

If I work until my delivery, can I collect benefits for a longer period of time after the birth?
No.  You may receive benefits only for the period of time that the doctor certifies you are physically unable to work.

If I deliver my baby early, will I receive the same amount of benefits as a woman who delivers on her due date?
Not necessarily.  Benefits are payable only for the period your doctor certifies you are disabled.  It cannot be adjusted because you delivered early.

Is my employer required to hold my job for me if I stop working due to pregnancy?
The New Jersey Temporary Disability Insurance Law does not require an employer to hold a job for someone who is on disability.  However, you may have job retention rights under other State or Federal Laws.  For further information contact the nearest office of the New Jersey Division of Civil Rights listed in your local telephone book.

Can I collect disability benefits if my doctor determines that my job environment is potentially harmful to my baby?
If you are physically able to do your job, but you are exposed to environmental risks at the worksite (for example, x-rays, radiation, or chemicals) disability benefits may not be payable because you are not disabled.  In this situation, you may have benefit rights under the Unemployment Insurance program.Contact the Division of Unemployment Insurance for additional information.

To protect my benefit rights, should I ask my employer for a leave of absence rather than quit outright?
Yes.

Can I collect disability benefits if my baby is sick?
No.  You must be disabled to receive benefits on your claim.

Questions Frequently Asked By Employers

What is a base year?
For a State Plan claim, the base year is the 52 calendar weeks immediately preceding the week in which the claimant is disabled.  For a Disability During Unemployment claim the base year is the first four of the last five completed quarters preceding the date of the claim.

How do I, as an employer, report money that is paid to the claimant after a disability claim has been filed?
If you pay the claimant money during a period of disability, the amount of benefits paid may be affected.  To report the money paid to the claimant, you should notify this office in writing.  Include the claimant's name, Social Security number, the type of payment, amount paid, and the period covered by those payments.  For further information, see our web page entitled Continued Pay.

Why am I the chargeable employer on my employee's disability claim?
The most recent employer is the chargeable employer under New Jersey's Temporary Disability Insurance Law.  Under the provisions of the New Jersey Unemployment Compensation Law, all covered base year employers proportionately share the benefit charge associated with a UI claim.  But this is not possible under the Temporary Disability Insurance Program because it encompasses both State Plan and Private Plan coverage.  If a disability claim were filed, and that claimant had both State Plan and Private Plan employers in the base year, there would be no way to charge the Private Plan employer since no contributions are paid to the TDI Trust Fund.

The type of disability coverage of the claimant's last employer determines who is responsible for processing the claim and paying benefits.  If you have State Plan coverage for your employees, State Plan Operations is responsible for processing the claim and paying benefits.  If you have Private Plan coverage, your Private Plan carrier assumes responsibility for the claim.

Can I refuse to provide wage information?  Are there penalties for not complying with a wage request?
Under New Jersey Law, employers are required to provide all requested wage information.  Failure to do so will result in penalties.  If you have doubts about the authenticity of a disability claim, complete the wage request form and request an independent medical examinations for the claimant at the same time.

Can an employer request an independent medical examination?
Yes.  As the employer, you have the right to request an exam.  Make your request as soon as a problem with a claim is suspected.  For information on how to make this request, see our web page entitled Independent Medical Examinations.

Frequently Asked Questions Pertaining to Private Plan Coverage

How is a Private Plan established?
See our web page entitled Approval of Private Plans.

Must all Private Plans be written by an insurance company?
No.  An employer may self-insure the Private Plan.  Or, the Private Plan may be funded through a labor-management agreement.

Can employees be required to contribute to the cost of a Private Plan?
Yes, but the cost can be no more than what they would have contributed for State Plan coverage.  For further information, see our web page entitled Cost.

Can an employer insure some employees through a Private Plan, and others through the State Plan?
Yes, as long as the selection will not result in a substantial risk adverse to the State Plan.  For example, production workers may be insured through a Private Plan and all other workers by the State Plan.  Another example is to insure employees with less than a year of employment through the State Plan and all other employees under a Private Plan.

Does the Division of Temporary Disability Insurance have to be notified if Private Plan benefits are denied?
Yes.  Copies of all denials of Private Plan benefits must be forwarded to the Private Plan Compliance Section, Claims Review Unit, Private Plan Operations, PO Box 957, Trenton, NJ  08625-0957.  Denials must advise claimants of their appeal rights.