Temporary Disability Insurance
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If you have not signed into this website since December 31, 2017, you will have to create a new account by clicking on "First Time User? Click Here"
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File an online claim for Temporary Disability Insurance Benefits...
If your own illness, injury or pregnancy:
- prevents you from working
- and was not caused by your job
File online because:
- You will get your benefits faster!
- You will get immediate confirmation that we received your claim.
- It’s safe and secure.
- You’ll be able to see the information your health care provider and employer submit (Under the Web Services tab, choose Print Forms).
- If you will be unable to work due to pregnancy or a scheduled surgery, you can start the claim process early. You can start an online application up to 14 days in advance, then complete and submit the claim online when you become unable to work.
Be advised that that there are multiple parts to a Temporary Disability application. While we would like to process your claim quickly, payment of benefits will be delayed if you fail to submit all of the required documents, or if there is missing, incorrect or conflicting information on your application. Remember - all documents submitted must have your Social Security Number on them. Take the time to carefully review your claim and supporting documents before filing. Only when all claim information has been received can we begin the claim review process. Claim review generally takes 14 days after the receipt of all complete application parts.
Important Information About the Application Process:
Disability claims require information from you, your doctor and your employer. All parts can be completed online.
After you complete your part of the application, it is your responsibility to make sure
1) your health care provider submits the medical certification to confirm the period you are unable to work, and
2) any employer(s) you worked for in the last 6 months submit an employer statement to confirm the employment that establishes your benefit amount
When you have completed your part online, bring your health care provider and employer(s) the instructions for them to complete their portion online with their unique "Online Form ID". They will complete their parts by going to www.nj.gov/labor, choosing Temporary Disability and Family Leave Insurance from the left navigation bar, and then choosing either the Health Care Provider or Employer button in the window.
Before you file your claim online, please have the following information:
- Name, address, and phone number of the health care provider treating you within 10 days of the first day you were unable to work.
- Dates of any emergency/urgent care treatment or hospitalization.
- Dates you worked for any employers in the last year, the employers’ addresses/phone numbers and the address where you worked. If you are applying online, you will need to know the dates of any paid time off you received after the first day of disability.
- Date you recovered (if you have recovered already) or estimate of when you expect to return to work.
The online claim application may prompt you to print out a form, so you may need access to a printer.
If you file online and do not complete the application on your first attempt, you can return to complete the form. Your information will be saved up to the last full page you completed.
Temporary Disability issues benefits by Bank of America debit cards. As of 7/24/17, debit cards will be issued when your claim is entered into our system rather than at the time an eligible determination is made. Benefits will be deposited on this debit card if your claim is approved. For additional details go to the DTDI Debit Card Information page.
If you submit your claim online, do not mail or fax a paper application.
If you submit duplicate forms, payment of your benefits will be delayed.
Don’t want to file your Temporary Disability Insurance claim online?
Download and Print out a claim form to fax or mail in to apply for temporary disability insurance benefits.
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
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If you have not signed into this website since December 31, 2017, you will have to create a new account by clicking on "First Time User? Click Here"
Click HERE to complete your Continued Claim Information online
If you are currently receiving NJ State Plan Temporary Disability benefits, instructions for providing certification of your continuing disability will automatically be mailed to you before your last authorized benefit payment.
Click on the link above and use the "Form ID" number on the Request to Claimant For Continued Claim Information (P30) notice you received in the mail to file your request for additional benefits.
Once you complete your section of the application, you will need to print instructions for your health care provider to file the continuing medical certification online. You will be considered for additional benefits after the medical certification is submitted.
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
Click HERE to complete your initial Medical Certificate (M01) online
Please note: If you submit your information online, do not also mail or fax a form. Doing so will delay the processing of the claim.
NEW! Click HERE to EXTEND your patient's Medical Certificate (M03) online
When completing your M01 or M03 certificates, please note: If your license number is two letters, followed by a zero, and then followed by 5 digits, please enter the license number without the initial zero. Ex. MA07563200 should be entered as MA75632.
Temporary Disability Insurance (TDI) Information for Health Care Providers and Patients:
As a resource to help your patients we have created a free one-page instruction sheet on how to apply for Temporary Disability Insurance.
Click HERE to download the one-page information sheet on TDI for your patients.
How to file your Medical Certification online- Click here for your step-by-step guide to the online application process.
Guide to Temporary Disability Insurance for Medical Providers
Data Privacy and Security Statement: The information collected as a result of your medical certificate is private data and cannot be released except when authorized by state or federal law, by court order or with your patient's permission. Precautions are taken to keep the information you provide in this application private and secure. The online application uses a secure connection and the data submitted is encrypted.
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
Click HERE to complete your Employer Statement (E01) online
Please note: If you submit your information online, do not mail or fax the form. Doing so will delay the processing of the claim.
Temporary Disability Insurance (TDI) Information for Employer Human Resource Departments and Employees: To help your human resource department and employees, we have created a free one-page instruction sheet on how to apply for Temporary Disability Insurance.
Click HERE to download the one-page information sheet on TDI for your employees.
Guide to Temporary Disability Insurance for Employers
How to file your Employer Statement online- Click here for a step-by-step guide on how to use the online application.
How to submit wage information for claims(DS1 - Part C or E15 form)
The Division of Temporary Disability and Family Leave Insurance will not accept printed payroll records as proof of weekly wages or continuation pay. Any payroll records received will be destroyed and will not be used to determine the eligibility of your employee for benefits.
Effective January 18, 2018, requests for information from this Division must be completed and returned within 10 days per N.J.A.C 12:18-3.7 (a). Failure to do so could result in a penalty.
Data Privacy and Security Statement:The information collected as a result of your employer statement is private data and cannot be released except when authorized by state or federal law, by court order or with your employee's permission. Precautions are taken to keep the information you provide in this application private and secure. The online application uses a secure connection and the data submitted is encrypted.
Information for employers and insurers about the programs administered by the Division of Temporary Disability Insurance.
State Plan Disability Program
Private Plan Disability Program
Disability During Unemployment Program
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
Need to change your name or address? Now you can do it online here.
Most employers in New Jersey are required to have temporary disability insurance (TDI) for their employees.
TDI insures workers in case they suffer an illness or disability that
• prevents them from working, and
• is not related to their work.
Employers may choose an insurance plan offered by the state or by a private insurance company. If
you become disabled while you are employed or within 14 days of your last day of work, ask your
employer whether their disability insurance is through a “state plan” or “private plan.” If they
have a state plan, file your claim for temporary disability benefits here. If they use a private insurance
company, you will file a claim through that company. Your employer can tell you how.
To learn about the types of disability benefits, click on a link below
State Plan Disability
Private Plan Disability
Disability During Unemployment If you become disabled more than 14 days after your last day of work, our Disability During Unemployment section will take care of your claim.
How to Repay Overpaid Benefits
Annual Reports
Work-related Disability
If you have become disabled due to injury or illness that is job related, contact the Division of Workers' Compensation
If your disability is work related and your employer's workers' compensation carrier
-denies you benefits or
-stops benefit payments
you may file a claim with the Division of Temporary Disability Insurance. See the Work-related Disabilities page for more information.
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:0am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
YOUR SELF-SERVICE APPLICATIONS
If you have not signed into this website since December 31, 2017, you will have to create a new account by clicking on "First Time User? Click Here"
Due to scheduled maintenance, the "Print Forms" and "Address Change" applications are temporarily unavailable.
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Web Inquiry- If you have filed a claim for State Plan Temporary Disability you will be able to view and print basic claim and payment information for any claim you filed in the past 1,000 days. |
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Complete a Claim - If you started your application before your first day of disability, use this link to complete and submit the claim once you become unable to work. |
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Print Forms - If you filed a claim online, reprint any of the forms required at the initial filing of your claim. View or print any health care provider or employer statement submitted through the web application. |
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Address Change - Click here to change your name and/or address on your most recent Temporary Disability claim. If you are doing a name change, remember to also edit your Department of Labor and Workforce Development Logon ID with your changes through LWD Profile. |
Health Care Provider - Please use health care provider tab to complete an M01 online.
Employer - Please use the employer tab to complete an E01 online.
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
Debit Card Information
Frequently Asked Questions
Contact Us
Other Government Assistance
Annual Reports
Employer Handbook
TDI Law & Regulations
Temporary Disability Insurance Brochures
HIPAA Requirements
Report Fraud
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Click here for Tax Information about your Temporary Disability benefits.
To obtain information on how to contact the offices within the Division of Temporary Disability Insurance click on the link provided.
STATE PLAN OPERATIONS
PRIVATE PLAN OPERATIONS
DISABILITY DURING UNEMPLOYMENT
Contact a Customer Service Representative at 609-292-7060
Call Center Agents are available the following hours:
8:00am - 5:30pm Monday – Friday (except holidays)
8:00am - 1:00pm Saturday
Contact us by email HERE. We provide an email response in 24 to 48 hours.
Click here for Tax Information about your Temporary Disability benefits.
