Division of Temporary Disability and Family Leave InsuranceURL reading ( My Leave Benefits . NJ . Gov )

How to Submit Wage Information

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We review the employee's quarterly earnings to approve benefit applications for both Temporary Disability Insurance and Family Leave Insurance.

In the event that we do not have enough information to approve a claim based on the reported calendar earnings and the employee's statement, you may be required to provide information.

In These Cases, You Will Be Notified

You will receive in the mail a request for information (form E-10) or request for additional wage information (form E-20). The wage and employment information you provide is required to determine their claim, so please complete and return this form promptly. Failure to do so can result in a denial of benefits and a monetary penalty.

Fax: 609-984-4138

Mail to: Division of Temporary Disability and Family Leave Insurance
              PO Box 387
              Trenton, New Jersey 08625-0387

An Additional Layer of Verification

We also check applications against the wage record maintained by the Division of Employer Accounts to make sure all employers and wages are accounted for. If the application for benefits, is completed before your employee stops working, we may also send a form to reconfirm the information.

Be Prompt to Avoid Fines

You are required by law to supply the requested wage information. If you do not comply within 10 days from the date of mailing, a $250 penalty will be assessed by the Division. If you receive a wage request for someone who is not or was not your employee, note that on the form and return it to our office promptly to avoid the penalty.

Helpful Tips

  1. If you receive a paper wage report request (Form E-20):
    1. Complete and return the form within 10 days from the date of mailing to avoid penalties.
    2. Include the employee's Social Security number on all pages.
    3. Complete both sides. Date and sign the form and include a telephone number where you can be reached. Do not post-date the form.
  2. Verify the claimant's Social Security number with your records.
  3. Give exact dates. The last day worked is particularly important. Remember, this is the last day the employee physically worked, not the last day the employee received compensation (wages, paid sick time, etc.), or the end date of that pay period.
  4. If you paid the applicant any money during the disability period, provide the exact beginning and ending dates for which the payment was allocated (not necessarily the pay period dates), the gross amount, and the type of continued pay (sick pay, vacation pay, etc.).
  5. All money amounts should be gross figures. Wages should include tips, overtime, and commission.
  6. If you need to include additional information, attach a note to your form.
  7. If a form was mailed to an incorrect address, update the address when you return the form.

For more information, please contact us.