Limitation of Benefits – State Plan Employer Information
Each claim is reviewed to determine if the claimant meets certain eligibility criteria. In addition to wage and medical requirements, there are other reasons why an individual may not be eligible to receive State Plan temporary disability benefits.
Those reasons are:
Those reasons are:
- The disability does not exceed seven days in length. The first seven consecutive days of each period of disability is known as the "waiting week". The waiting week becomes payable when disability benefits have been paid for all or some part of each of the three weeks immediately following the waiting week.
- The claimant has already received 26 weeks of benefits for this period of disability. The maximum number of weeks allowable for any one period of disability is 26.
- The claimant became disabled more than 14 days after the last day of work for a New Jersey covered employer. This individual may be eligible for benefits through the Disability During Unemployment Program.
- The claimant is not under medical care. He/she must be under the care of a legally licensed physician, dentist, podiatrist, chiropractor, optometrist, psychologist, certified nurse midwife, or advanced practice nurse.
- The disability resulted from the commission of a criminal act or was self-inflicted.
- The claimant was discharged by his or her most recent employer for gross misconduct connected with the work because of a commission of an act punishable as a crime under the New Jersey Code of Criminal Justice.
- The claimant worked and received wages after the period of disability began.
- The disability began during a labor dispute at the claimant's most recent place of employment.
- The claimant continues to receive wages from the most recent employer which together with the temporary disability benefits exceeds their regular weekly wages immediately prior to the onset of the disability.
For example: The claimant earned $500 per week prior to becoming disabled. The weekly benefit rate is determined to be $333. The employer continues to pay the claimant $200 per week during the disability period. The weekly benefit rate ($333) plus $200 salary equals $533, which exceeds the claimant's regular weekly wage. Therefore, the weekly benefit rate would be reduced by $33 per week.
- The claimant is a covered government worker and has not exhausted all accumulated sick leave.
For other prohibitions to the payment of benefits refer to Nonduplication of benefits