Healthcare Providers' Frequently Asked Questions
![A female nurse or doctor talking to a doctor in a hospital setting.](/labor/myleavebenefits/assets/images/960x480/ThinkstockPhotos-200020984-001_960x480.jpg)
Get answers to questions about your patients' and their caregivers' Temporary Disability and Family Leave Insurance claims.
Yes, medical providers can certify a patient’s need for gender affirmation procedures, including but not limited to, top surgery, bottom surgery, facial feminization or masculinization, voice surgery, tracheal shaving, etc. Medical providers can also certify the need for a patient’s loved one to help them recover. The definition of loved one is generous.
No. The N.J.S.A. 12:18-1.6 prohibits charging a fee to complete Temporary Disability forms.
Yes. Precautions are taken to keep the information that you provide in the online application private and secure. The online application uses a secure connection and the data submitted is encrypted.
No. A disability claim cannot be filed until the period of disability actually begins.
In order to certify the patient is under continuous medical care, and because the outcome of a patient’s condition can change at any moment, we require the physician to routinely certify medical information for the duration of the claim. We typically issue benefits for the onset of the disability period, and request an updated medical statement to extend the benefits further.
No. You do not have to physically treat the patient on the same day they became disabled. You must be treating the patient within 10 days from the start of their disability period.
Click here to view the list of approved medical practitioners.
There are various reasons the online medical application may not allow you to proceed.
You should be aware that you may only complete your patient’s medical statement online while their claim is status pending. Once an application for benefits is either approved or denied, information can no longer be submitted online. In that case, you can submit medical information by faxing or mailing to the division a paper application (Part C).
Another reason you may have trouble accessing the online medical application is that the claimant may have provided you the incorrect Form ID. If the Form ID you have does not work, reach out to your patient to confirm.
Currently our online medical application works best by using the Internet Explorer web browser. If you’re using a different browser, such as Firefox or Google Chrome, you may also experience difficulties.
Yes. The New Jersey Temporary Disability Benefits program is not a covered entity under HIPAA. All medical records are confidential and are not open to public inspection.
Benefits are usually payable up to four weeks before the expected date of delivery, and up to eight weeks after delivery. If your patient is medically unable to work outside of this time frame, the division will ask if there are complications associated with the pregnancy. It is important to know that the complications must be current to this pregnancy and must affect the mother, not only the fetus. Having a history of complications does not prove the patient is unable to work now.
No. While hospital records often provide useful information; they do not always address the specific requirements that we need to approve a claim. For example, if a patient goes to the emergency room for testing, the hospital records will show that they were there for testing and what the findings are, but may not clearly state the patient is medically unable to work and the diagnosis that prevents them from working. Therefore, completing the questions specifically asked of you on the medical certificate ensures that the information you provide is sufficient.
Yes, medical providers can certify a patient’s need for gender affirmation procedures, including but not limited to, top surgery, bottom surgery, facial feminization or masculinization, voice surgery, tracheal shaving, etc. Medical providers can also certify the need for a patient’s loved one to help them recover. The definition of loved one is generous.
The start of the Family Leave claim is the first date that care is provided to your patient. The patient’s condition may be preexisting, but the caregiver’s claim is specific to when they stopped working to care for their family member.
Click here to view the list of approved medical practitioners.
Yes, pregnancy is a condition that may require care from a family member.
No. The N.J.S.A. 12:18-1.6 prohibits charging a fee to complete Family Leave Insurance forms.
Yes. Precautions are taken to keep the information that you provide in the online application private and secure. The online application uses a secure connection, and the data submitted is encrypted.
There are various reasons the online medical application may not allow you to proceed.
You should be aware that you may only complete your patient’s medical statement online while their caregiver’s claim is status pending. Once an application for benefits is either approved or denied, information can no longer be submitted online. In that case, you can submit medical information by faxing or mailing to the division part C of the paper application.
Another reason you may have trouble accessing the online medical application is that your patient's caregiver may have provided you the incorrect Form ID. If the Form ID you have does not work, reach out to your patient’s caregiver to confirm.
Currently our online medical application works best by using the Internet Explorer web browser. If you’re using a different browser, such as Firefox or Google Chrome, you may also experience difficulties.
The NJ Temporary Disability Benefits Program is not a “covered entity” under the Federal Health Information Portability and Accountability Act (HIPAA). All medical records of the Division, except to the extent necessary for the proper administration of the Temporary Disability Benefits Law are confidential and are not open to public inspection. The Division protects all records that may reveal the identity of the claimant, or the nature or cause of the disability and the records may only be used in proceedings arising under the Law.