Official Site of The State of New JerseyTemporary Disability and Family Leave Insurance
NJ Temporary Disability Insurance provides cash benefits to employees for up to 26 weeks in New Jersey who are unable to work due to a physical or mental health condition or other disability unrelated to their work, including pregnancy/childbirth recovery.
Temporary Disability Insurance is a wage replacement program and it does not provide job protection. However, during the period in which an employee receives these benefits, their job may be protected under federal law. In addition, if an employer retaliates against an employee for taking or seeking to take Temporary Disability Insurance benefits, they have the right to take private legal action.
You are required to pay disability insurance taxes and to give the Division of Temporary Disability Insurance certain information about your employees when they file claims for disability benefits. Therefore, you should be familiar with sections of the Temporary Disability Benefits Law covering initial and continuing eligibility for benefits and the amount of benefits a claimant may receive.
Learn more about the Temporary Disability Insurance program, click here.
NJ Family Leave Insurance provides cash benefits to employees in New Jersey who are unable to work because they need to:
- Care for a family member with a physical or mental health condition
- Bond with a newborn, newly adopted or newly placed foster child
- Handle certain matters related to domestic or sexual violence.
Workers can collect Family Leave Insurance benefits for a maximum of 12 consecutive weeks in a 12-month period, or up to eight weeks (56 individual days) in a 12-month period, if taking leave in a non-continuous manner.
Family Leave Insurance is a wage replacement program, and it does not provide job protection. However, during the period in which an employee receives these benefits, their job may be protected under state or federal law. In addition, if an employer retaliates against an employee for taking or seeking to take Family Leave Insurance benefits, they have the right to take private legal action.
To learn more about Family Leave Insurance, click here.
A New Jersey employer subject to the Unemployment Compensation Law is also subject to the Temporary Disability Benefits Law, except for certain government entities that are excluded from automatic disability insurance coverage. A subject employer is automatically covered under the State Plan unless workers are covered under an approved private plan for temporary disability insurance.
Employees can apply for Temporary Disability Insurance benefits online, by mail, or by fax. Instructions are included on the application. Employees must read all the instructions carefully before completing the application. We’ll need information from the employee and their medical provider. There is not an employer portion of the application. The employee should complete the first two sections of the application.
They must include:
- The last day they physically worked
- The first day they were unable to work, and under the care of a health care provider
- All employment from the past 18 months, with accurate dates and work locations
- Dates of any paid time off or other benefits received after the last day they worked
- It is the employee’s responsibility to have all this information – including the medical provider part – submitted to us online, by mail, or by fax.
To establish a valid claim, a worker must have had at least 20 base weeks of New Jersey covered employment or, in the alternative, must have earned an amount, determined annually, in covered employment during the base year. The standard base year refers to the first four of the last five completed calendar quarters before the worker files a claim. A base week is a calendar week in the base-year during which the worker earned a required amount in covered employment; that is, an amount equal to 20 times the state minimum hourly wage.
Under the Temporary Disability Benefits Law, Average Weekly Wage is calculated by taking the total base year earnings divided by the actual number of base weeks in the base year. The result is then multiplied by 85% to obtain the weekly benefit rate.
The weekly benefit amount is figured individually on the basis of the claimant’s average weekly wage. Each claimant is paid 85% of their average weekly wage, up to a maximum amount payable, determined annually, for disabilities beginning during each calendar year. The maximum weekly amount is recalculated annually and is equal to 70% of the statewide average weekly wage. There is no provision in the law for the payment of dependency benefits to disability claimants.
The maximum amount of benefits that may be paid for each period of disability is one-third of the total wages in New Jersey covered employment paid to the worker during the base-year, or 26 times the weekly benefit amount, whichever is less.
In order to medically substantiate a claim, the claimant may be required to submit, not more than once per week, to an examination by a licensed medical practitioner. In addition, the employer may request an independent medical examination if there is good cause to suspect that the employee is not disabled.
There is no cost to the employee or the employer for the examination. Failure to submit to an examination is cause for denial of benefits. For more information about the medical examination process or to request a medical examination, complete an online request through our website or FAX 609-292-1692.
If you have reason to believe that an employee is collecting temporary disability benefits and working for another employer, you can report suspected fraud by completing an online form on our website.
If the claimant indicates on a claim form that they worked for you at some time during their base-year period, the Division may send you a wage report request. You are required by law to supply the requested wage information. If you do not return the form within 10 days of the mailing date, a $250 monetary penalty may be assessed.
The employer that the claimant last worked for prior to the disability period will assume all the charges for benefits paid for that period of disability, even if the employee only worked part-time, and/or worked there briefly.
Benefits payable under the Temporary Disability Benefits Law are considered “third party sick pay.” Federal law provides that the portion of gross disability benefits paid, which is attributable to the chargeable employer’s contributions for disability insurance coverage, is subject to federal taxation for Social Security, Medicare, FUTA and federal income tax.
Based on the chargeable employer’s average experience rate for State Plan temporary disability insurance during the most recent three years, the Division calculates the worker’s portion of Social Security (FICA) contributions and Medicare contributions of each benefit authorization. That amount is deducted from the benefits to be paid to the claimant and is forwarded to a federal depository. To calculate the FICA and Medicare contribution that you, the employer, must remit to the federal government, refer to the “Taxable Amount” column on the Division’s Form DS-7C, “Notice of Disability Benefits Charged or Credited.” The figure in this column specifies the portion of benefits to use in calculating the employer’s contribution at the applicable employer rate.
Upon the claimant’s completion of Form W4S, “Request for Federal Income Tax Withholding from Sick Pay,” a federal income tax deduction may also be made from the payable disability benefit gross amount. This deduction is indicated on Form DS-7C in the “Federal Tax Withheld” column. The employer is not required to match this withholding amount.
If you have questions about payment of FUTA taxes on the portion of paid benefits that is attributable to your disability insurance contributions as an employer, direct them to the Internal Revenue Service. The Division makes no deduction from paid benefits to meet employer FUTA liability.
If a worker disagrees with a determination on a disability claim and wishes to appeal, they can complete an online form through our website or send the appeal in writing. If an employer disagrees with a determination on a disability claim and wishes to appeal, they can complete an online form through our website or send the appeal in writing. The appeal must be received or postmarked within seven days after delivery or ten days after the date of the mailing of the determination. However, if a claimant disagrees with a demand for refund of disability benefits, he/she must do so in writing within 20 calendar days after delivery of the notice or 24 days after the mailing date of the notice. If the appeal is not filed within the required time limits, an explanation of the reason for the delay must be provided. The appeal period will be extended only if good cause for filing late is shown. Good cause exists when it can be shown that the delay was due to circumstances beyond the appellant’s control, which could not have been reasonably foreseen or prevented. An appeal that is filed late without good cause will be dismissed.
A worker who becomes totally disabled and who has been out of covered employment for more than 14 days may be eligible for benefits under the Disability During Unemployment program.
Claims filed under this program are governed by both the Unemployment Compensation and Disability Benefits laws. However, these claims are primarily unemployment insurance claims, established under Section 4(f) of the Unemployment Compensation law. Therefore, to be eligible for benefits, the claimant must meet all the requirements of this law, and be totally unable to work. The claimant must also be under the care of a legally licensed physician, dentist, podiatrist, optometrist, chiropractor, psychologist, or advanced practice nurse.
To have a valid 4(f) claim, the claimant must have been paid a minimum amount of wages while in a job covered by New Jersey’s disability insurance program during the base period of the claim. Employment with local governments that have not elected disability coverage for their workers is not covered for disability benefits; nor is out-of-state employment, even though it is covered for unemployment insurance.
If the claimant has an unemployment insurance claim and becomes disabled while unemployed during the benefit year, they may be paid 4(f) benefits against the claim. In most cases the claimant will receive the same weekly rate as was received on the unemployment insurance claim. The maximum that one can collect on unemployment insurance and 4(f) benefits combined is one and one-half times the maximum benefit amount of the claim.
Information necessary to determine eligibility is obtained from the claimant, to whom we mail a packet of forms the claimant must complete and return. This includes dependency information, as well as student, corporate officer or pension status. Separation information is also obtained from the employer. Both the claimant and the employer have opportunities for rebuttal through telephone calls, which are documented by memoranda.
Upon receipt of all information, a determination will be made. It remains in effect and is applicable to any claim that the claimant might make during the same benefit year for unemployment insurance benefits.
The Temporary Disability Benefits Law allows employers the option of choosing to establish a private plan for the payment of temporary disability benefits instead of the mandated State Plan. All private plans must be approved by the Division of Temporary Disability Insurance before they become effective. Covered employers with approved private plans are relieved of employer contributions to the State Disability Benefits Fund, as are their workers, as long as coverage is continued under the private plan.
A subject employer may opt for a private plan for the payment of disability benefits instead of the mandated State Plan. A private plan may be established by submitting an application through an approved insurer, self-insurance, or union welfare fund.
For more information on private insurance plans, click here.
All private plans must be approved by Private Plan Compliance Section. At a minimum, approved private plans must meet the basic provisions required of State Plan. Under a private plan:
- Benefits paid must be at least equal to the amount that would be paid on a State Plan claim.
- Eligibility requirements cannot be more restrictive than they would be for a State Plan claim.
- Coverage must be at least equal to that offered by the State Plan.
- Neither the employer, nor their workers are required to contribute to the State's Temporary Disability Insurance Trust Fund while the private plan remains in existence. The cost to the worker for the private plan cannot be more than it would be under State Plan.
- A written election must be held, unless waived, if the plan is contributory and covers members of a Collective Bargaining Agreement. A majority of employees must agree to the plan prior to the effective date of the plan.
Any modification to an existing, approved private plan requires an application and must be approved by Private Plan Compliance Section before they can take effect.
Some examples of a private plan modification (or change) would be:
- Insurance carrier
- The class of employees covered by the plan
- Eligibility requirements
- Benefits
A private plan may be terminated by the company upon proper notice in writing to the Private Plan Compliance Section. A termination request may be submitted by an employer, insurer or workers, in addition, the Division may terminate a private plan for cause.
After a private plan is terminated, coverage under the State Plan is automatic effective the day following termination. No application forms are required of the employer or the workers to begin State Plan coverage. In such cases, liability for contributions to the State Plan is also effective immediately.
Benefits are payable to covered employees from either the New Jersey State Plan, or from a state-approved employer-provided private plan, to:
- Bond with a child during the first 12 months after the child’s birth, or during the first 12months after the placement of the child with the covered individual for adoption.
- For bonding claims after the birth of a child, the applicant or the applicant’s spouse, domestic partner, or civil union partner must be the biological parent of the child.
- Care for a family member with a serious health condition that is supported by a certification from a health care provider.
Claims may be filed for consecutive weeks, for intermittent weeks, or for intermittent days during a 12-month period, beginning with the first date of the claim.
“Family member” means a spouse, domestic partners, children of any age, parents, parents-in-law, grandparents, grandchildren, siblings, chosen family, any other individuals related by blood, any other individuals with whom you consider to be family.
“Child” means a biological, adopted, or foster child, or resource family child, stepchild, legal ward, or a child of a parent, including a child who becomes the child of a parent pursuant to a valid written agreement between the parent and a gestational carrier.
A person can apply online, or print a paper application (FL-1), and mail it back to us at Division of Temporary Disability & Family Leave Insurance, P.O. Box 387, Trenton, NJ 08625-0387, or fax it to 609-984-4138.
Instructions are included on the application. Employees must read all the instructions carefully before completing the application. We’ll need information from the employee and their loved one’s medical provider (if applicable). There is not an employer portion of the application. Employees must complete the first two sections of the application. They must include:
- The last day they physically worked
- The first day their leave began
- If they are taking their leave in one continuous period or intermittently up to 56 individual days
- All employment from the past 18 months, with accurate dates and work locations
- Dates of any paid time off or other benefits received after the last day they worked
If the employee is receiving State Plan temporary disability benefits for pregnancy, after the child is born, the Division will automatically mail Form FL-2, Family Leave Insurance Benefits – New Mother Bonding to the employee. This form gives information about filing a claim for Family Leave Insurance benefits to bond with the newborn child. If the claim is filed for the period immediately after the employee recovers from her pregnancy-related disability, in most cases, she will receive the same weekly benefit amount she was paid for her pregnancy-related disability claim.
To establish a valid claim, a worker must have had at least 20 base weeks of New Jersey covered employment or, in the alternative, must have earned an amount, determined annually, in covered employment during the base year. The standard base year refers to the first four of the last five completed calendar quarters before the worker files a claim. A base week is a calendar week in the base-year during which the worker earned a required amount in covered employment; that is, an amount equal to 20 times the state minimum hourly wage.
The average weekly wage is calculated by taking the total base year earnings divided by the actual number of base weeks in the base year. The result is then multiplied by 85% to obtain the weekly benefit amount.
The weekly benefit amount is figured individually on the basis of the claimant’s average weekly wage. Each claimant is paid 85% of their average weekly wage, up to a maximum amount payable, determined annually, for leave beginning during each calendar year. The maximum weekly amount is recalculated annually and is equal to 70% of the statewide average weekly wage.
For bonding claims, an employee must give 30 days’ notice if taking family leave bonding in one continuous period, and 15 days' notice if taking leave in a non-continuous manner. For caregiving claims, an employee must give reasonable notice if taking leave in one continuous period unless there are unforeseen or emergency circumstances. If taking leave in a non-continuous manner, an employee must give 15 days' notice before each anticipated absence.
If the claimant indicates on a claim form that they worked for you at some time during their base-year period and we need additional information, the Division may send you a wage report request. You are required by law to supply the requested wage information. If you do not return the form within 10 days of the mailing date, a $250 monetary penalty may be assessed.
Employees do not need to take their leave all at once. Family Leave Insurance allows an employee to bond in one consecutive 12-week period, or on a day-by-day basis to suit their needs. However, the manner chosen to claim leave will determine the entitled duration of leave.
Continuous Leave: Employees can collect a maximum of 12 consecutive weeks in a 12-month period, or one-third (1/3) of the total gross wages earned during the base year, whichever is less.
Non-Continuous (intermittent) Leave: If claiming benefits on an intermittent schedule, whether it be a week, a month, or a day at a time, an employee may receive up to 56 individual days (8 weeks) of Family Leave benefits in a 12-month period, or one-third (1/3) of the total gross wages earned during the base year, whichever is less. If the employee’s leave is taken in a non-continuous manner, they should let us know those dates after taking each segment. If they are approved for Family Leave Insurance benefits but do not initially claim your maximum amount of leave when filing, they will need to submit an updated schedule after each period of leave is completed.
An employer cannot require an employee to use company paid time off. If an employee chooses to use accrued sick or vacation time, it will not reduce the maximum duration of leave that they are entitled to. Any day that an employee receives full wages in paid time off, they cannot also receive Family Leave benefits for that same day.
A subject employer may opt for a private plan for the payment of family leave insurance benefits instead of the mandated State Plan. A private plan may be established by submitting an application to the Private Plan Compliance Section through an approved insurer, self-insurance, or union welfare fund. A written election must be held, unless waived, if the plan is contributory and covers members of a Collective Bargaining Agreement. A majority of employees must agree to the plan prior to the effective date of the plan.
If the period of Family Leave begins more than 14 days after the last day of covered employment and there is a separation from employment, the individual may be eligible for benefits under the Family Leave During Unemployment program. The individual must meet all requirements for unemployment benefits, except that they are not required to show availability for work. If the individual is on an approved leave of absence from covered employment, the individual may be eligible for benefits under the State Plan Family Leave Insurance Program.
If a worker disagrees with a determination on a family leave claim and wishes to appeal, they can complete an online form through our website or send the appeal in writing. If an employer disagrees with a determination on a family leave claim and wishes to appeal, they can complete an online form through our website or send the appeal in writing. The appeal must be received or postmarked within seven days after delivery or ten days after the date of the mailing of the determination. However, if a claimant disagrees with a demand for refund of family leave benefits, they must do so in writing within 20 calendar days after delivery of the notice or 24 days after the mailing date of the notice. If the appeal is not filed within the required time limits, an explanation of the reason for the delay must be provided. The appeal period will be extended only if good cause for filing late is shown. Good cause exists when it can be shown that the delay was due to circumstances beyond the appellant’s control, which could not have been reasonably foreseen or prevented. An appeal that is filed late without good cause will be dismissed.
