Official Site of The State of New Jersey

Apply for Temporary Disability Insurance benefits only when you have stopped working and your doctor certifies that you are unable to work due to your pregnancy.

You can apply for Temporary Disability Insurance benefits online, in the mail, or by fax. Instructions are included on the application. Read all the instructions carefully before completing the application. If filing by mail or fax, don’t forget to sign and date the form.

When you apply for Temporary Disability Insurance benefits, we’ll need information from you, and your medical provider. It is your responsibility to have all this information – including the medical provider part – submitted to us online, by mail, or by fax. 

This is the information we need to complete your application:

1. From you:
   • Your Social Security number, contact information, and date of birth
   • The date you became disabled
   • Contact information for the medical provider who treated you within 10 days of the first day you were unable to work
   • Dates of any emergency/urgent care treatment or hospitalizations
   • Dates you worked for any employers in the last 18 months, the employers’ contact information, and the address(es) where you worked
   • Dates of any paid time off or other benefits you received after the last day you worked
   • The date when you expect to recover and return to work (or the date you recovered and returned to work)
     
     
2. From your doctor:
   • A medical certification to confirm the period you are unable to work

When you complete your part online, you will get a unique Online Form ID number to give to your medical provider. They will use this number to submit their part to us online. You will be prompted to print out (or save as a PDF file) a page that has your unique Online Form ID number, along with instructions for your medical provider to follow. If you do not have access to a printer when initially filing your application, you have a fourteen day window to return and print the instructions when a printer is available. You can do so by clicking Access claim documents at the top of this page. 

If planning ahead, you may start your online application up to 60 days in advance. To avoid deletion of your draft application: (1) within 14 days of starting the application, provide all information and confirm your claim; then (2) within 14 days after the start of your leave, certify and file your claim.

If applying after your leave begins, you have 30 days' from your first day of leave to file your application.

We would like to process your claim quickly, but can’t do it without your help.

Keep these tips in mind to avoid delays and receive your benefits faster:

1. Apply online. It’s faster than printing and mailing or faxing your application to us. It also allows your medical provider to easily complete their section online after you pass along their part of the application. Remember, it is your responsibility to give these instructions to the medical provider to complete – they are not automatically notified by our system.
2. Fill out your application completely and accurately. Read all instructions first. If you’re not sure how to answer a question, check out our FAQ or Form Look Up for more information. If you still need help, contact us.
3. Include your Social Security number on all correspondence.
4. Don’t fax us pictures of documents. If you want to submit a digital copy of a document, use a free mobile app like Adobe Scan or Dropbox to transform a mobile phone picture into a high-contrast, black-and-white PDF file you can print and fax.
5. Get ready to receive your payments. Money Network/My Banking Direct will mail your prepaid debit card in a plain envelope (which might even look like junk mail), so check all your mail carefully. If you already have a debit card from a previous Temporary Disability, Family Leave, or Unemployment Insurance claim, we will use that same card to pay benefits for new claims. If you can’t find your card, contact Money Network/My Banking Direct for a replacement.

New Jersey workers are encouraged to apply.

In order to have a valid claim for Temporary Disability Insurance, you need to have paid into the program through your employment and meet minimum gross earnings requirements (listed below.) Temporary Disability Insurance is available to most New Jersey workers.

Exemptions include: 

• federal government employees
• optional for local government, including school district employees
• out-of-state employees
• faith-based organizations
• workers that are not technically employees (such as contractors).

If your employer is covered for Temporary Disability Insurance, they are required to set up payroll contributions for you. If you believe you are covered under the program but payroll contributions have not been made, you are still encouraged to apply as it may have been an error.  If you became unemployed recently and have a need for Temporary Disability Insurance, you still may be eligible for benefits and we encourage you to apply. In that case, we will forward your application to our Disability During Unemployment section.

Your employer is required to report your wages to the state after each calendar quarter. When your claim is under review, we consider the earnings reported for the 5 completed quarters prior to the week your leave began. The first 4 quarters of that time frame is called the base year.   

To qualify for Temporary Disability Insurance in 2023, you must have worked 20 weeks earning at least $260 weekly, or have earned a combined total of $13,000 in those four quarters (the base year). 

To qualify for Temporary Disability Insurance in 2024, you must have worked 20 weeks earning at least $283 weekly, or have earned a combined total of $14,200 in those four quarters (the base year). 

Your regular base year period consists of 52 weeks and is determined by the date you apply for Temporary Disability Insurance benefits, as outlined in the chart below:

The wages earned during your base year will determine the amount of weekly benefits you may receive, and the maximum amount of benefits you can claim.

For workers who don't qualify with a standard base year, we have other ways of calculating a base year. Click here for more information on these alternate base years. 

1. First, we calculate your average weekly wage. We do this by dividing your base year earnings by the number of base weeks.
    In 2023, a "base week" is any week you earn $260 or more. 
    In 2024, a "base week" is any week you earn $283 or more.

2. Now, we can determine your weekly benefit rate. Claimants are paid 85% of their average weekly wage, up to the maximum weekly benefit rate set for that calendar year.
    In 2023, the maximum weekly benefit rate is $1,025 per week.
    In 2024, the maximum weekly benefit rate is $1,055 per week. 

For example, let’s say Sarah's first day of disability is Friday, March 1, 2024. To see how much she would receive weekly on Temporary Disability Insurance, we look at her reported wages for the first four of the last five completed quarters: 

Quarters 1 through 4 are the regular base year and the timeframe used to calculate her benefits.

Total base year earnings: $18,200 which we divide by 45 (the number of base weeks)

This gives us an average weekly wage of $404.

Sarah’s weekly benefit rate is 85 % of her average weekly wage: $343.

Benefits are usually payable up to four weeks before the expected date of delivery, and up to six weeks after you give birth (or up to eight weeks after a Caesarean delivery). If your doctor certifies that complications exist more than four weeks before your expected delivery date or longer than eight weeks after the birth, benefits may be payable for a longer period.

Applications are processed in the order they are received. Payment of benefits will be delayed if your application is incomplete or contains missing or conflicting information. You also must have your healthcare provider submit their information as soon as possible to have your application processed and any benefits paid promptly.

We start paying Temporary Disability benefits on the eighth consecutive day of your leave, due to a seven-day period called the waiting week. You will retroactively receive benefits for that first week after you’ve been out on leave for 22 days without being paid by your employer.

Benefits are issued on a debit card sent to you directly by Money Network/My Banking Direct. You will receive this card in the mail in a plain, unmarked envelope once your claim is approved. Don’t lose it!

Payments are usually issued every two weeks after the initial payment, with a one-week lag for processing time. Once a payment is posted, funds should be available on your debit card within three business days of the payment date. FICA and Medicare deductions are automatically withheld from your benefits. However, no federal income tax is withheld from your benefits unless you request a specific amount to be withheld weekly when you apply.

The most you can be paid for each period of disability is one-third (1/3) of the total wages you earned in New Jersey covered employment during the base year, or 26 times the weekly benefit amount, whichever is less.

Here is a list of the important mail you’ll receive from us, in the order it’s typically sent:

1. C-05 - Confirmation of Claim Receipt: This form lets you know we received your application. Don’t discard it! You’ll need it if you have to update any of your information (name, address, earlier return to work date, etc.).
   
   
2. D-10 - Eligible Notice: This form tells you that your application for benefits has been approved.
   
   
3. D-30 - Ineligible Notice: This form tells you that your application for benefits has been denied.
   
   
4. P-30 - Request to Claimant for Continued Claim Information: If your Temporary Disability Insurance application is approved, we will send this form so you can extend or end your benefits online when the time comes.
   
   
5. FL-2 - New Mother Bonding Notice: If you received state plan Temporary Disability Insurance benefits for your pregnancy, wait for us to mail you the New Mother Bonding Notice (FL2) to apply for Family Leave Insurance benefits. We send you the FL2 after you or your healthcare provider tell us that you gave birth, whether it was a C-section or vaginal delivery, and confirm your delivery date. 

You also may receive one or more of the following if your application contains missing or conflicting information:

1. C-10 - Request to Claimant for Information: You’ll receive this form if your application has missing or conflicting information.
   
   
2. M-10 - Request for Medical Information: You’ll receive this form if your application is missing medical information, if the medical information needs further review, or if your statement conflicts with the medical provider’s statement.

For more information about specific forms or notices, see our Form Look Up page

The Temporary Disability Benefits Law does not specify how far in advance you must notify your employer for medical leave, as many disabilities including complications during pregnancy are unforeseeable circumstances. However, we encourage you to keep your employer informed whether your leave for medical reasons is scheduled in advance or not. Having an open discussion with your employer about your need for leave will allow them to prepare for your absence and make adjustments to work schedules, if necessary. Your employer may also be able to provide insight on job protection and if you qualify for it through the Federal Family and Medical Leave Act (FMLA).

Both New Jersey workers and employers contribute to the cost of the temporary disability program. Workers contribute through deductions taken out of their paychecks.

For 2022, workers contribute 0.14% on the first $151,900 (wage cap) in covered wages earned during this calendar year. The maximum worker contribution for 2022 is $212.66. This contribution is in the form of a salary deduction that your employer takes from your weekly wages.

There will be no Temporary Disability worker contribution deductions for the 2023 and 2024 calendar years.

If you disagree with our decision, you may submit an appeal. Click here for more information about the appeals process.

Did you receive a Demand for Refund (P60) notice in the mail? We try to make the process of repayment as easy as possible. Click here for more information about the repayment process.

Temporary Disability Insurance benefits are considered taxable income for purposes of both the federal income tax and FICA (Social Security). Federal income tax will not be withheld from your benefit payment each week unless you request it when you file, or submit IRS form W-4S to us (for state plan claims) or your employer (for private plan claims). Your share of FICA and medicare is automatically deducted from state plan benefit payments. Garnishments and any refunds owed from a previous disability or family leave claim will also be withheld from your benefit payments. Temporary Disability Insurance benefits are not taxed by the State of New Jersey.

The amount of your benefits that is taxable will be reported to your employer in January of the year following the receipt of your benefits. Your employer will include that information on your W-2 annual earnings statement, often listed as "third party sick pay" or "other wages." Keep in mind, benefits are federally taxable during the year that payments are issued, which may not always match up with when your leave occurred. 

If your Temporary Disability benefits are not reported on your W-2, contact your employer directly to have it corrected. If needed, let your employer know they can download their year-end tax statement here. For additional information on incorrect W-2s, go to: Internal Revenue Service (IRS).

The Temporary Disability Benefits law allows employers to provide coverage through an approved private plan instead of the state plan.

The plan may be insured by the employer, an insurance company, or a union welfare fund.  Private plans must offer at least the same benefit amounts, eligibility requirements, and duration of payments as the state plan.

If you are covered under a private plan for your pregnancy disability period, your employer's insurance carrier is responsible for processing and paying benefits on your claim. 

Click here for more information on Private Temporary Disability Insurance. 

Family Leave Insurance provides New Jersey workers monetary benefits to bond with a newborn. While most New Jersey workers who take family leave are covered under the state’s Family Leave program, some employers provide Family Leave Insurance through a plan with a private insurance carrier instead. If you are not sure about your coverage, ask your employer.

AFTER RECEIVING STATE TEMPORARY DISABILITY BENEFITS: You will receive an FL2 (new mother bonding notice) in the mail once we are notified that you delivered. The FL2 has a unique Claim ID Number on it. When you receive the form, click here and enter that number when asked. If everything goes smoothly, you should receive benefits on your debit card within two business of completing the FL2 online.

IF YOU RECEIVED PRIVATE PLAN TEMPORARY DISABILITY BENEFITS, OR NO DISABILITY BENEFITS: You will need to submit a new application for Family Leave Insurance benefits for bonding with your baby. Click here to start that process. If planning ahead, you may start your online application up to 60 days in advance. To avoid deletion of your draft application: (1) within 14 days of starting the application, provide all information and confirm your claim; then (2) within 14 days after the start of your leave, certify and file your claim. If applying after your leave begins, you have 30 days from your first day of leave to file your application.

We would like to process your claim quickly, but can’t do it without your help.

Keep these tips in mind to avoid delays and receive your benefits faster:

1. Apply online. It’s faster than printing and mailing or faxing your application to us. It also allows your medical provider to easily complete their section online once they get the required instructions from you. Remember, it is your responsibility to give these instructions to your medical provider to complete – they are not automatically notified by our system.
2. Fill out your application completely and accurately. Read all instructions first. If you’re not sure how to answer a question, check out our FAQ or Form Look Up for more information. If you still need help, contact us.
3. Include your Social Security number on all correspondence.
4. Don’t fax us pictures of documents. If you want to submit a digital copy of a document, use a free mobile app like Adobe Scan or Dropbox to transform a mobile phone picture into a high-contrast, black-and-white PDF file you can print and fax.
5. Get ready to receive your payments. Money Network/My Banking Direct will mail your prepaid debit card in a plain envelope (which might even look like junk mail), so check all your mail carefully. If you already have a debit card from a previous Temporary Disability, Family Leave, or Unemployment Insurance claim, we will use that same card to pay benefits for new claims. If you can’t find your card, contact Money Network/My Banking Direct for a replacement.

New moms do not need to take their leave all at once. You can claim Family Leave Insurance to bond in one consecutive 12-week period, or on a day-by-day basis to suit your needs. However, the manner in which you choose to claim your leave will determine the duration of leave that you are entitled to. 

Continuous Leave: You may receive up to 12 weeks of benefits before your child’s first birthday, if the benefits are claimed for one continuous period of unpaid leave.

Non-Continuous (intermittent) Leave: If you are claiming benefits on an intermittent schedule, whether it be a week, a month, or a day at a time, you may receive up to 56 individual days (8 weeks) of Family Leave benefits before your child’s first birthday. If you take your leave in a non-continuous manner, let us know those dates after taking each segment. If you are approved for Family Leave Insurance benefits but do not initially claim your maximum amount of leave when filing, we will mail you a Continued Claim Certification (FL3), which includes a schedule that you must fill out and sign – showing the days you did not work during the period. You will need to submit an updated schedule after each period of leave is completed. 

New Jersey workers are encouraged to apply.
In order to have a valid claim for Family Leave Insurance, you need to have paid into the program through your employment and meet minimum gross earnings requirements (listed below.) Family Leave Insurance is available to most New Jersey workers.

Exemptions include: 

• federal government employees
• out-of-state employees
• faith-based organizations
• workers that are not technically employees (such as contractors).

If your employer is covered for Family Leave Insurance, they are required to set up payroll contributions for you. If you believe you are covered under the program but payroll contributions have not been made, you are still encouraged to apply as it may have been an error.  If you became unemployed recently and have a need for Family Leave Insurance, you still may be eligible for benefits and we encourage you to apply. In that case, we will forward your application to our Family Leave During Unemployment section.

Your employer is required to report your wages to the state after each calendar quarter. When your claim is under review, we consider the earnings reported for the five completed quarters prior to the week your leave began. The first four quarters of that time frame is called the base year.  

To qualify for Family Leave Insurance in 2023, you must have worked 20 weeks earning at least $260 weekly, or have earned a combined total of $13,000 in those four quarters (the base year).

To qualify for Family Leave Insurance in 2024, you must have worked 20 weeks earning at least $283 weekly, or have earned a combined total of $14,200 in those four quarters (the base year).

The minimum earnings requirement for Temporary Disability and Family Leave Insurance are the same. Therefore, if you received Temporary Disability benefits from the state for your pregnancy and postpartum recovery, you automatically meet the minimum earnings requirement for Family Leave benefits.

Your regular base year period consists of 52 weeks and is determined by the date you apply for Family Leave Insurance benefits, as outlined in the chart below:

The wages earned during your base year will determine the amount of weekly benefits you may receive, and the maximum amount of benefits you can claim.

For workers who don't qualify with a standard base year, we have other ways of calculating a base year. Click here for more information on these alternate base years. 

If you received Temporary Disability Insurance benefits from the state for your pregnancy and postpartum recovery, your weekly benefit amount for Family Leave Insurance will be the same. If you received benefits from a private plan, we will match that rate, up to the maximum weekly benefit rate set for that calendar year.

All Other Claims
If you did not receive disability insurance through either the state program or a private insurance company, the weekly benefit rate for Family Leave Insurance is based on your earnings in the base year.

1. First, we calculate your average weekly wage. We do this by dividing your base year earnings by the number of base weeks. 
   In 2023, a "base week" is any week you earn $260 or more. 
   In 2024, a "base week" is any week you earn $283 or more.
   
   
2. Now, we can determine your weekly benefit rate. Claimants are paid 85% of their average weekly wage up to the maximum weekly benefit rate set for that calendar year.
   In 2023, the maximum weekly benefit rate is $1,025 per week.
   In 2024, the maximum weekly benefit rate is $1,055 per week.

For example, let’s say Sarah's first day of leave is Friday, March 1, 2024. To see how much she would receive weekly on Family Leave Insurance, we look at her reported wages for the first four of the last five completed quarters: 

Quarters 1 through 4 are the regular base year and the time frame used to calculate her benefits.

Total base year earnings: $18,200 which we divide by 45 (the number of base weeks).

This gives us an average weekly wage of $404.

Sarah's weekly benefit rate is 85% of her average weekly wage: $343.

If Sarah is taking her leave on a day by day basis, she would receive 1/7 of her weekly benefit rate for each day she claims.

Applications are processed in the order they are received. Payment of benefits will be delayed if your application is incomplete or contains missing or conflicting information.

Benefits are issued on a debit card sent to you directly by Money Network/My Banking Direct. You will receive this card in the mail in a plain, unmarked envelope once your claim is approved. Don’t lose it!

Payments are usually issued every two weeks after the initial payment, with a one-week lag for processing time. Once a payment is posted, funds should be available on your debit card within three business days of the payment date. No federal income tax is withheld from your benefits unless you request a 10 percent deduction when you apply. Each day of benefits paid to you is one-seventh (1/7) of your weekly benefit rate. Payment may be more or less than a one-week period.

You may choose to use accrued paid time off before claiming Family Leave benefits, although your employers cannot require it. If you choose to use paid time off before claiming Family Leave Insurance benefits, it will not reduce the maximum duration of benefits to which you are entitled. This means that if you utilize employer paid time off to bond with your new child, it is in addition to the total duration of Family Leave benefits you may claim. 

Workers can receive benefits for up to 12 consecutive weeks (84 days) or up to eight weeks (56 days) of intermittent leave in a 12-month period. 

The 12-month period begins on the date of your child's birth. If you have not claimed your maximum benefit amount, you may reestablish a claim within the same 12-month period to care for a family member, or during or following employment with a different employer.

To receive Family Leave benefits in one continuous period, you must notify your employer 30 days’ in advance of the date you plan to start your leave. To claim your benefits in non-consecutive days, you must notify your employer 15 days’ in advance of each anticipated absence. 

We encourage you to keep your employer informed. Having an open discussion with your employer about your need for leave will allow them to prepare for your absence and make adjustments to work schedules if necessary. Your employer may also be able to provide insight on job protection and if you qualify for it through the federal Family and Medical Leave Act (FMLA) or the New Jersey Family Leave Act (NJFLA). 

Employees with more than one job may collect Family Leave Insurance benefits for leave taken from work with one employer while continuing to work for another, provided that the employee does not exceed their usual work schedule in the second job. The employee's weekly benefit rate will be based only on wages from the employment from which they are taking leave. An eligible employee who has two part-time jobs may take leave from both and receive Family Leave Insurance. 

The family leave program is financed 100% by worker payroll deductions. Employers do not contribute to the program.

For 2023, workers contribute 0.06% on the first $156,800 (wage cap) in covered wages earned during this calendar year. The maximum worker contribution for 2023 is $94.08. This contribution is in the form of a salary deduction that your employer takes from your weekly wages.

For 2024, workers contribute 0.09% on the first $161,400 (wage cap) in covered wages earned during this calendar year. The maximum worker contribution for 2024 is $145.26. This contribution is in the form of a salary deduction that your employer takes from your weekly wages.

After the end of each calendar year, Form 1099-G will be available online for you to download and use when filing your federal income tax return. This form lists the total New Jersey State Family Leave Insurance (including Family Leave During Unemployment) benefits received that calendar year. This information is also sent to the Internal Revenue Service (IRS). If you receive Family Leave Insurance benefits from an approved private plan, your employer will provide you with the information required to file your federal income tax return. Family Leave Insurance benefits are not taxed by the State of New Jersey.

We send you the FL2 after you or your healthcare provider tell us that you gave birth, whether it was a C-section or vaginal delivery, and confirm your delivery date. To notify us of your delivery information, complete the Request to Claimant for Continued Claim Information (Form P30). If you have not received the P30 in the mail yet, you can have your doctor complete Part C of the Temporary Disability Insurance application (Form DS-1). If you received state plan Temporary Disability Insurance benefits for your pregnancy, wait for us to mail you the New Mother Bonding Notice (FL2) to apply for Family Leave Insurance benefits. Don’t try to speed things up by sending in an application for Family Leave Insurance (FL-1) before you get the FL2. Doing so will significantly delay the payment of your Family Leave Insurance benefits.

Typically, if your delivery date isn’t verified, we will pay you up to four weeks before and four weeks after your estimated due date. We know that estimated due dates aren't set in stone, so this period is designed to cover you until we receive confirmation of your delivery date.

If complications arise more than four weeks before your estimated due date, your healthcare provider must certify that the complications prevent you from working. Remember, we can only accept certification of complications that have already come up, not problems that your healthcare provider anticipates may happen. For example, your provider can’t tell us that you will need to stop work next week to go on bedrest. He or she must certify your disability on the first day you are unable to work.

After delivery, we will continue paying Temporary Disability benefits beyond the standard 6 or 8-week timeframe only if your healthcare provider certifies the disabling postpartum complication that is keeping you from returning to work.