NJ TDI provides up to 26 weeks of benefits for non-work-related disability

Benefits are 85% of average weekly wage, up to the state maximum (updated annually)

There is a 7-day waiting period before benefits begin

Employment / FMLAmoderate

New Jersey Temporary Disability Insurance Claim

NJ TDI · New Jersey Department of Labor and Workforce Development

Application for Temporary Disability Insurance benefits in New Jersey. Provides cash benefits for non-work-related illness or injury preventing employment.

Form Details

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Frequency: per incident
State-specific: Yes — form may vary by state

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Where to Submit This Form

🌐

NJ DOL Online (recommended)

https://myleavebenefits.nj.gov/worker/tdi/

File online through NJ's myLeave Benefits portal.

📬

Mail to NJ Division of Temporary Disability Insurance

Division of Temporary Disability Insurance PO Box 387 Trenton, NJ 08625-0387

Filing Deadline

Within 30 days of the date your disability begins. Late filing may reduce or eliminate benefits.

Required Attachments

📎 Medical certification (Part C of the claim form) completed by your healthcare provider
📎 Employer information and wage details

Processing Time

Approximately 2-4 weeks from receipt of a complete application.

What Happens Next

The Division will review your claim and issue a determination. If approved, weekly benefits are 85% of your average weekly wage, up to the state maximum.

Tips for This Form

✓ NJ TDI provides up to 26 weeks of benefits for non-work-related disability
✓ Benefits are 85% of average weekly wage, up to the state maximum (updated annually)
✓ There is a 7-day waiting period before benefits begin
✓ If your disability is related to pregnancy, you may also be eligible for NJ Family Leave Insurance (FLI): https://myleavebenefits.nj.gov/

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