Here are just a few of the most common queries clients have.
New Jersey Temporary Disability Benefits FAQs
1. Do I have to live in New Jersey to receive temporary disability benefits
A. No. The most important eligibility requirement is whether or not you work for a New Jersey covered employer.
A. You can obtain a claim form (WDS-1) directly through this website under NJ TDB Forms. You can also request a claim form from your employer, the NJ Department of Labor (DOL) or the unemployment office.
A. Yes. You have 30 days from the first day of disability to file your claim. If your claim is received more than 30 days from the start of the disability, you must show good cause why the claim was not filed timely. If good cause is not shown, benefits may be reduced or denied.
A. There is no set requirement about the frequency of your visits. To continue receiving benefits you must be under the continued care of your doctor. Periodically, forms will be mailed to you to obtain updated medical information. To continue benefits those forms must be completed by you and your physician and returned to National Benefit Life Insurance Company, Attn: TDB Claims, JAF Box 2366, New York, NY 10116.
A. Your weekly benefit is two-thirds (2/3) of your average weekly wage during the eight calendar weeks prior to your disability. Each year the state re-sets the maximum benefit. For disabilities beginning in 2009 the maximum benefit is $546 per week. The maximum benefit you can collect is one-third (1/3) of the total wages you earned working in New Jersey during the base year (last 52 weeks) or 26 times the weekly benefit, whichever is less.
A. Benefits are payable on the eighth consecutive day of your disability. The first seven days of disability is called the waiting week. If your disability continues for 21 days, you will also receive benefits for the waiting week.
A. Provided no additional information is needed, it generally takes about 10 days to receive a decision. However, if your claim does not contain all the required information, it will take longer to process. That is why it is important to have your employer and your physician complete their portions of the form before mailing it to us.
A. No. Work-related injuries or illnesses are not compensable under the Temporary Disability Benefits Law. However, if you file a claim for Workers' Compensation benefits and it is contested by the Workers' Compensation insurance carrier, you may be eligible for temporary disability benefits while the Workers' Compensation issues are being resolved. To protect our subrogation rights, we would file a lien against the Workers' Compensation award.
am still disabled. Can I now collect State Plan benefits?
A. No. Coverage under an approved Private Plan replaces State Plan coverage. Contact your Social Security office about Social Security Disability.
required to go?
A. Yes. During your period of disability you may be required to go to a doctor for an independent medical examination. Failure to keep the appointment could result in your disability benefits being discontinued.
my Private Plan claim. Can I file an appeal?
A. Yes. You may file an appeal with the Private Plan Compliance Section, Claims Review Unit.
A. Yes. A portion of disability benefits is considered taxable income for both the Federal Income Tax and FICA (Social Security). The portion of the benefits payment that is taxable is that portion attributable to the employer's disability contribution. NBL will withhold and report the worker's share of FICA from benefit payments. Federal income tax is withheld only if requested by the Claimant. Upon receipt of the prescribed form W4-S, NBL will deduct Federal taxes from the claimant’s benefit payment. The minimum withholding is $20 per week.
A. Yes. Eligibility for temporary disability benefits due to pregnancy is determined in the same manner as for any other disability.
A. When you have stopped working and your doctor certifies that you are disabled, complete the claim form WDS-1 and fax it to (800) 584-9303 or mail to National Benefit Life Insurance Company, Attn: TDB Claims, JAF Box 2366, New York, NY 10116. Do not file the claim before you stop working or before your physician says you are disabled. If you file the claim while you are still working, or before the doctor certifies that you are disabled, your claim may be denied.
A. For a normal pregnancy, benefits are usually payable for up to four (4) weeks before the expected delivery date and up to six (6) weeks after the actual delivery date. Benefits may be payable for a longer period if your doctor certifies that you have a specific complication related to the pregnancy; you have a Caesarian section; or you have another simultaneous disability.
