Limitation of Benefits - State Plan
Each claim is reviewed to see if the claimant meets certain eligibility criteria. In addition to wage and medical requirements, there are other reasons why an individual would not be eligible to receive State Plan temporary disability benefits. 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.
- You have 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.
- You 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
- You are not under medical care. You must be under the care of a legally licensed physician, dentist, optometrist, podiatrist, practicing psychologist, advanced practice nurse, certified nurse midwife, or chiropractor.
- The disability resulted from the perpetration of a criminal act or was self-inflicted.
- You were discharged by your 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.
- You worked and received wages after the period of disability began.
- The disability began during a labor dispute at your most recent place of employment.
- You continue to receive wages from your employer which together with your temporary disability benefits exceeds your regular weekly wages immediately prior to the onset of the disability.
For example: You earned $500 per week before becoming disabled. Your weekly benefit rate is determined to be $333. The employer continues to pay you $200 per week during the disability period. The weekly benefit rate ($333) plus $200 salary equals $533, which exceeds your regular weekly wage. Therefore, your weekly benefit rate would be reduced by $33 per week.
- You are a covered government worker and have not exhausted all accumulated sick leave.
For other prohibitions to the payment of benefits refer to the following pages:
