The NJ Temporary Disability Form, officially known as the DS-1, is a crucial document for employees in New Jersey who have stopped working due to a disability and need to claim temporary disability benefits. This form helps in providing the necessary information to the Division of Temporary Disability Insurance, ensuring that the process to claim these benefits is initiated effectively. It’s important for claimants to understand their responsibilities and the rules for filing a claim, including the timely submission of the form and the process for appealing any decisions. To ensure you receive the benefits you are entitled to, click the button below to start filling out the NJ Temporary Disability Form.
The New Jersey Temporary Disability Form, referred to as DS-1, serves a pivotal role in providing financial support to those unable to work due to a temporary disability. The responsibility for filing this form rests with the claimant, who must submit it promptly after stopping work. It’s essential to note that filing late can lead to denied or reduced benefits, with the law requiring submission within 30 days from the disability's start date. The form encompasses several sections, each demanding accurate completion by the claimant, their physician, and employer. In addition to personal and employment details, claimants must disclose other benefits they may be receiving, such as sick pay or workers’ compensation. The form also includes provisions for appeal should the claimant disagree with the initial determination. Misrepresentation or failure to disclose material facts are serious offenses that could lead to legal repercussions. With ample instructions for completion and a designated section for additional employer information, the form is designed to ensure all relevant information is captured efficiently. Furthermore, the inclusion of a medical certificate section underscores the necessity of medical validation for the claim. All of this underscores the importance of the DS-1 form in the broader context of New Jersey’s Temporary Disability Insurance program, aiming to provide a streamlined process for claimants to receive their deserved benefits.
DIVISION OF TEMPORARY DISABILITY INSURANCE
CLAIM FOR DISABILITY BENEFITS (DS-1)
DETACH THIS PAGE AND KEEP FOR YOUR RECORDS
CLAIMANT RIGHTS AND RESPONSIBILITIES
RULES FOR FILING A CLAIM AND APPEAL RIGHTS
1.It is your responsibility to file this claim form promptly after you stop working due to your disability. Filing your claim before your last day of work will delay its processing. The law requires that claims must be filed within 30 days after the beginning of the disability. Benefits may be denied or reduced if the claim is filed late. If your claim is filed beyond the thirty day period, please use the space provided on the reverse side of Part A to give your reasons for the late filing.
2.If you disagree with a determination on your claim and wish to appeal, you must do so in writing within ten days from the date the decision was mailed. You do not need a lawyer at the appeal hearing.
CLAIMANT RESPONSIBILITIES:
1.Your signature certifies that you understand any misrepresentation of fact or failure to disclose a material fact may be punishable under the law. This includes any changes to the Medical Certificate or the Employer’s Statement made by you without authorization by your physician or your employer.
2.You must inform us of any other payments you are receiving such as sick pay or wages, a pension from your last employer, worker’s compensation benefits, Social Security Disability benefits, or disability benefits from your employer or union.
3.If you receive a request for continued medical certification (Form P30), you must have your physician complete and sign the form. You should return it promptly.
4.When you recover or return to work, you must report this date immediately to the Division of Temporary Disability Insurance.
5.If you are requesting voluntary Federal Income Tax (F.I.T.) deductions to be withheld from your disability benefits, attach Form W-4S (Request for Federal Income Tax Withholding From Sick Pay) to your claim. Forms should be obtained from your employer or the Internal Revenue Service.
6.If your home and/or mailing address changes, you must notify the Division of Temporary Disability Insurance, PO Box 387, Trenton, NJ 08625-0387 immediately in writing. Notification must include your Social Security Number and signature.
CLAIM ASSISTANCE:
If you require any assistance with your claim, call:
•Customer Service Section (609) 292-7060.
•Telecommunication Device for the Deaf (TDD) (609) 292-8319
•New Jersey Relay Service: TT user 1-800-852-7899
Voice User: 1-800-852-7897
Important: Please allow fourteen (14) days processing time before inquiring about your claim.
Division of Temporary Disability Insurance FAX number: (609) 984-4138
For additional information about the Temporary Disability Benefits Program, visit our website at: www.nj.gov/labor
NOTE: If your disability is expected to last for one year or longer, you may be eligible for Federal Social Security Disability Benefits.
Toll Free number for Social Security: 1-800-772-1213.
READ THE FOLLOWING INSTRUCTIONS BEFORE COMPLETING THE ATTACHED FORM,
CLAIM FOR DISABILITY BENEFITS – DS-1
1.Complete both sides of the claimant’s portion of this form (Part A & A1.) YOU ARE RESPONSIBLE for having Part B completed by your doctor and Part C by your last employer. If you have worked for more than one employer during the past year, you may copy Part C for completion by the other employer(s) to avoid processing delays. Any missing or incorrect entries on this form will delay processing of your claim. If you cannot have Parts B and/or C completed timely, complete Part A and A1 and return the application as soon as possible.
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REMEMBER SENDING IN SEPARATE PARTS OF THE APPLICATION WILL DELAY YOUR CLAIM. NOTE: IF YOU CHOOSE TO FAX THIS FORM TO OUR OFFICE, BE SURE TO COPY THE BACK SIDE OF EACH PAGE AND FAX ALL FOUR PAGES AND ANY OTHER ATTACHMENTS. MAIL OR FAX PART A, PART A1, PART B AND PART C TOGETHER TO:
Division of Temporary Disability Insurance PO Box 387
Trenton, NJ 08625-0387
FAX No: (609) 984-4138
2.Read all questions carefully! Print or write clearly since this information is used to determine your right to benefits. If you need any assistance in completing this form, please call the Customer Service Section in Trenton at (609) 292-7060 and hold for an agent.
3.BE SURE TO WRITE YOUR SOCIAL SECURITY NUMBER AND NAME ON EACH PORTION OF YOUR CLAIM.
Instructions For Part A and A1 – Claimant’s Statement – Please complete all questions Items 1, 4 & 6
Item 3
Item 9
Items 12 –15
Item 18
Item 19
Part A1
In the event that you are unable to telephone our agency, you may designate a
Item 1 representative in this space to obtain information on your behalf. If there is no one listed, only YOU will be able to obtain information on your claim from this agency.
Item 2 Sign and date the claim form. Include your telephone number.
Important: We suggest that you keep a copy of the completed claim form for your records.
STATE OF NEW JERSEY – DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT
PART A
INFORMATION TO BE COMPLETED BY THE CLAIMANT – Print or Type
WDS-1(R-3-11)
1. Name: Last
First
Middle
2. Birth Date
|
4. Home Address – required (Street, Apt #, City, State, Zip Code)
3.Social Security Number
| |
5. County
6. Mailing Address – if different (Street, Apt #, City, State, Zip Code)
7.Male
8. Occupation
Female
9. Are you a citizen of the United States? Yes
No
10. Alien Reg. No.
11. Work Authorization
If NO, answer #10 & 11 and give country of origin: ______________
From ___________ To ___________
12a. What was the last day that you actually worked before your disability began?
Month
Day
Year
12b. Reason for separation:
Illness/Accident/Maternity
Terminated
Quit
13. What was the first day you were unable to work due to present disability:
(Include Saturday, Sunday, or Holiday) Do not list future dates
14.If you have recovered or returned to work from this disability, list date:
(Do not use dates in the future)
15. Date(s) of emergency room care:__________________ or hospitalization: From ___________________ To ___________________
Month/Day/YearMonth/Day/Year Month/Day/Year
16. Describe your disability (How, when, where it happened) _________________________________________________________
________________________________________________________________________________________________________________________________________
17. Was this injury/illness caused by your job?
Yes
or
If Yes, date of work related injury/illness:_________________
Was your employer notified that your injury was caused by your job?
(This question must be answered.)
or No
18. Identify the physician or hospital treating you for this disability: Name: ________________________________________________
Address: ____________________________________________________________ Telephone: (_____)_________________________
Employment Information – Beginning with your last employer, list all employment (both full and part-time) in the past 18
months. If you had more than 2 employers, list the remaining employers on the reverse side of this form in the space provided.
19a. Name and address of your most recent employer:
Period of employment: From _______________ To_____________
__________________________________________________
month/day/year
Work
Telephone: ____________________ Location _________________
(Street)
(City)
(State) (Zip)
City
State
Occupation: ________________________________ Full time
Part time
Union _____________ Division___________________
Check the days of the week you normally work. SUN
MON
TUE
WED
THUR
FRI
SAT
19b. Name and address:
(State)
(Zip)
Period of employment: From _______________ To____________
month/day/year month/day/year
City State
Union _____________Division___________________
20.Other Benefits – You Must Answer Each Question Listed Below For the Period of Disability Covered By This Claim:
a. Have you worked after your disability began? (Including self-employment)
b. Have you been receiving sick or vacation pay?
c. Have you been involved in a labor dispute?
21. Since your last day of work have you received, claimed or applied for: d. Any other disability benefits provided by your
a. Federal Social Security Disability Benefits?
employer or union?
b. Pension benefits from your most recent employer? Yes
e. Unemployment Insurance Benefits? Yes
c. Temporary Disability Benefits from another State? Yes
BE SURE TO COMPLETE AND SIGN PART A1
WDS-1 (R-3-11)
Claimant’s Name:_________________________________________
Claimant’s Telephone No: (_____)___________________________
Social Security Number
PART A1
CLAIMANT’S AUTHORIZATION AND CERTIFICATION STATEMENTS
MUST BE COMPLETED AND SIGNED BY THE CLAIMANT
1.Please designate a representative to obtain claim information for you if you cannot call this Agency yourself. The Law only permits claim information to be given to you or your representative.
Representative Name: ___________________________________________________Birth Date:_____________________________
Phone (______ )____________________________________
2.Certification and Signature I was unable to work during the period for which benefits are claimed and hereby certify that I have read and understand my benefit rights and responsibilities. I am aware that if any of the foregoing statements made by me are known to be false, or I knowingly fail to disclose a material fact, I may be subject to penalties, which may include criminal prosecution. You are hereby authorized to verify my Social Security Account Number, and obtain any medical, employment and Social Security benefit entitlement information that is necessary to determine my eligibility for benefits.
Sign Here ________________________________________________________________Date______________________________
Witness signature if claimant writes an “X” _______________________________________________________________________
Phone No. (_____)_____________________________ E-Mail Address _______________________________________________
Note: The NJ Temporary Disability Benefits Program is not a “covered entity” under the Federal Health Information Portability & 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 & 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.
USE THIS SPACE TO LIST ADDITIONAL EMPLOYERS FOR QUESTION 19.
Name and address:
Telephone: ______________ Location ______________________
USE THIS SPACE TO PROVIDE ANY ADDITIONAL INFORMATION FOR QUESTIONS ON PART A
_____________________________________________________________________________________________________________
If more space is needed, attach an additional sheet of paper. Be sure your Social Security Number appears on all pages.
Claimant’s Name: ________________________________________________
Claimant’s Address:_______________________________________________
Claimant’s Telephone No:(_______)__________________________________
PART B
MEDICAL CERTIFICATE
(TO BE COMPLETED BY YOUR DOCTOR AFTER YOU BECOME DISABLED)
1a. Patient has been under my care for this period of disability: FROM ____________________ TO __________________________
(Month/Day/Year) (Month/Day/Year)
b.Frequency of treatment: ___________________________________
c.
Patient was last treated by me on:
____________|___________|_________
2.
Enter the date the patient was unable to perform his/her regular work due to this disability: _______|___________|_________
3.
Estimated Recovery: (Give the approximate date patient will be able to return to work.)
4.
If now recovered, on what date was the patient first able to work?
5.Diagnosis: (nature and cause of this disability which prevents patient from working) ______________________________________
_____________________________________________________________________________ ICD Code: _____________________
Clinical data and tests to support diagnosis:__________________________________________________________________________
6a. If pregnancy, provide estimated date of delivery:
b.Complications, if any.____________________________________________________
c. If pregnancy terminated, enter the date:
And identify the reason:
Birth
C-Section
Miscarriage
Abortion
7a. Date(s) of emergency room care or hospitalization: FROM _________________________ TO _________________________
b.Name and address of any specialist treating patient: ____________________________________________________________
8.Type of surgery: _______________________ Date of Surgery __________________ Anticipated Surgery Date _________________
Is surgery for cosmetic purposes only?
9.
In your opinion, was this disability:
Due to an accident at work?
Not related to his/her work
Due to a condition which developed because of the nature of the work.
10.
Was this patient referred to you?
If yes, please supply the information below if available.
Name of referring doctor ______________________________Referring doctor’s telephone #:____________________
11. I certify that the above statements, in my opinion, truly describe the patient’s disability and the estimated duration thereof:
____________________________________________
_______________________________________ ______________________
(Print Doctor’s Name and Medical Degree)
(Original Signature of Doctor Required)
(Date Signed)
_______________________________________________________
_____________________________________________________
If Resident, check
(Address)
(Certificate License No. and State)
_______________________________________________________________
____________________________________________________________________
(Specialty of Treating Physician)
______________________________________________________________
(Zip Code)
Telephone Number: (
)______________________________
FAX Number: (
)_______________________________
1. Claimant’s Name: _______________________________Clt’s Tele #(____)______________
Clt’s Address:__________________________________________________________________
SOCIAL SECURITY NUMBER
PART C
TO BE COMPLETED BY YOUR EMPLOYER OR COMPANY REPRESENTATIVE
2. EMPLOYER STATUS
8. BASE WEEKS AND BASE YEAR GROSS
What is your Federal Employer Identification Number: ___________________
WAGES A BASE WEEK is a calendar week in
3. PRIVATE PLAN COVERAGE (NJ approved plan/replaces State Plan coverage)
which the claimant had New Jersey earnings of $145
a. Do you have a New Jersey approved Private Plan?
or more during the Base Year. The BASE YEAR is
b. If “Yes”, is claimant covered under this approved Private Plan?
the 52 calendar weeks preceding the week in which
4. LAST ACTUAL DAY WORKED before this disability
the disability occurred.
(do not use payroll week ending dates)
______|______|______
(Month
/
Year)
a. Total Number of Base Weeks _______________
a. Reason for separation from work if other than
disability _____________________________________________________
b. Total Gross Wages in Base Year ____________
b. Is lack of work:
temporary?
permanent?
Include all wages earned by the claimant
c. Has claimant returned to work?
__________________________________________
If “Yes”, give date
_______|_____|______
/ Year)
9. REGULAR WEEKLY WAGE $_____________
d. If the work was intermittent, list dates:_______________________________
5. CONTINUED PAY (do not enter wages earned prior to disability)
10. Weekly wages
a. Have you paid or expect to pay the claimant for any period after the last day
Indicate below: dates and claimant’s GROSS
of work?
earnings in N.J. employment during the listed
b. If “yes” give dates:
FROM ______|_____|_____ TO _____|_____|_____
calendar weeks.
(Month /
Day /
(Month / Day / Year)
Description of
Calendar
Gross
c. Amount per week $______________, if amount varies attach list of dates
Calendar Week
Week
Wages
and amounts.
Ending Date
d. Check the number that best describes the monies paid in item c.
Week Disability
1. Regular weekly wages and/or sick pay
Began
$
2. Regular vacation (if designated for a specific time period)
Week Before
3. Pension
Disability
4. Difference between regular weekly wage and disability benefits to be
2nd Week Before
received
5. Full salary advanced to effect #4 above
3rd Week Before
6. Supplemental benefits or gratuities
Note: Items 1, 2, and 3 may reduce benefits to the claimant
4th Week Before
6. GOVERNMENT EMPLOYEES (Complete this section)
a. Payroll number (For N.J. State Employees) ________________________
5th Week Before
b. Number of earned sick leave days as of the last day worked. ___________
c. Has the claimant filed for or received Employment Disability Leave
6th Week Before
(SLI)?
d. If claimant has applied for or received donated leave, attach dates and
7th Week Before
amounts on a separate sheet of paper.
7. WORKERS’ COMPENSATION LIABILITY
8th Week Before
a. Did the claimant’s disability happen in connection with his/her work or
while on your premises, or was the disability due in any way to his/her
9th Week Before
occupation?
b. If “Yes”, have you filed or do you intend to file a Workers’ Compensation
claim on behalf of this claimant?
10th Week Before
c. If “Yes,” list Workers’ Compensation insurance carrier below:
Name______________________________Telephone (
) _______________
TOTAL GROSS WAGES FOR
0
Address__________________________________________________________
ABOVE WEEKS
Policy #_______________________ Claim #___________________________
Are you exempt from FICA tax?
11. Check the days of the week the employee normally works. SUN
Firm Name __________________________________________I CERTIFY THE INFORMATION GIVEN ABOVE IS CORRECT
Address ____________________________________________ Signed_____________________________Date___________________
City, State, Zip_______________________________________ Print or Type Name _________________________________________
Mailing Address, If Different____________________________ Official Title_______________________________________________
FAX No. ( ) _______________________ Telephone (
) _____________________E-Mail Address_______________________
Filling out the NJ Temporary Disability Form can seem like a daunting task, but with clear instructions, it can be completed accurately and efficiently. This form requires careful attention to detail as it involves providing personal information, employment history, and medical details pertaining to your claim. To ensure a smooth process and prevent any delays in processing your claim, follow these step-by-step instructions. Remember, accurate and complete information is crucial for a successful submission.
After you submit your form, it's important to allow the Division of Temporary Disability Insurance at least fourteen (14) days to process your claim before inquiring about its status. Keeping a copy of the completed form and any correspondence for your records is a good practice. Ensuring that the information provided is accurate and complete will help avoid delays and ensure that your claim is processed as quickly as possible.
What is the New Jersey Temporary Disability Benefits form?
This form is used to apply for Temporary Disability Insurance (TDI) benefits in New Jersey. It's important for individuals who are unable to work due to a physical or mental disability. The form is divided into parts that require information from the claimant, their employer, and their doctor.
How do I file a claim for New Jersey Temporary Disability Benefits?
To file a claim, you must complete the DS-1 form. Fill out both sides of the claimant's portion (Part A & A1), have Part B completed by your doctor, and Part C by your last employer. Ensure all parts are filled correctly to avoid delays. Mail or fax the completed form and any additional attachments to the Division of Temporary Disability Insurance as instructed on the form.
When should I submit my Temporary Disability Benefits claim?
Submit your claim promptly after stopping work due to your disability. Do not file before your last day of work, as this will delay processing. Claims must be filed within 30 days after the beginning of the disability. Late filings may result in denied or reduced benefits. If you file late, explain your reasons in the designated space on the form.
What if I disagree with a decision on my claim?
If you disagree with a decision, you have the right to appeal in writing within ten days from when the decision was mailed. A lawyer is not required for the appeal hearing.
Are there any responsibilities I should be aware of while receiving Temporary Disability Benefits?
Yes. You must report any changes, such as going back to work or receiving other payments like sick pay, worker's compensation benefits, or pensions. If asked for continued medical certification, you must comply promptly, and you should inform the division if your address changes. Misrepresenting facts can lead to legal punishment.
What happens if I recover from my disability or return to work?
If you recover or return to work, report the date immediately to the Division of Temporary Disability Insurance. This ensures accurate benefit calculation and compliance with state laws.
Can I request federal income tax deductions from my Temporary Disability Benefits?
Yes. If you want federal income tax (F.I.T.) deductions withheld from your benefits, attach Form W-4S (Request for Federal Income Tax Withholding From Sick Pay) to your claim. Forms are available from your employer or the Internal Revenue Service.
Where can I find more information or get help with my claim?
For assistance, you can contact the Customer Service Section at (609) 292-7060. If you are deaf or hard of hearing, use the Telecommunication Device for the Deaf (TDD) at (609) 292-8319 or the New Jersey Relay Service. Additional information is also available on the New Jersey Department of Labor and Workforce Development's website.
Filling out the NJ Temporary Disability Form can sometimes be tricky, and making errors can delay your claim or even lead to denials. Among the common mistakes people make, one of the most significant is not filing the claim form promptly after stopping work because of a disability. The law requires filing within 30 days after the disability begins to avoid the risk of denied or reduced benefits. It's crucial to understand the importance of this timeline to ensure you receive the benefits you're entitled to without unnecessary delay.
Another frequent misstep involves the handling of Part B and Part C of the form, which must be completed by the doctor and the last employer, respectively. A common mistake here is not ensuring these parts are filled out completely and accurately before submission. People often send in Part A without waiting for Parts B and C to be completed, which leads to processing delays. Coordinating with your healthcare provider and your employer to have these sections filled out timely can streamline the process significantly.
Additionally, people sometimes provide inaccurate or incomplete information about other benefits they are receiving or may be eligible for, such as sick pay, worker's compensation, or Social Security Disability benefits. It's crucial to disclose all such benefits accuratelysince this information is used to determine your eligibility and the correct benefit amount you're entitled to receive. Not disclosing this information or doing so incorrectly can cause complications with your claim.
Neglecting to report a return to work or recovery from disability immediately is another mistake that can affect your claim. Once you're able to return to work or have recovered from your disability, it's your responsibility to inform the Division of Temporary Disability Insurance right away. Failing to do so could result in the need to repay benefits you received after you were no longer eligible.
Finally, a simple but impactful error is the failure to report changes in personal information, such as a new address. If the Division cannot reach you because of outdated contact information, you may miss important notifications about your claim. Ensuring that your contact details, especially your address and phone number, are current and accurately listed on the form is an easy step that can prevent unnecessary setbacks in receiving your disability benefits.
When submitting a claim for New Jersey Temporary Disability, it's crucial to be thorough. Completing the necessary paperwork accurately and providing all required documentation can significantly impact the processing time and outcome of your application. Alongside the NJ Temporary Disability form, there are several other forms and documents that could be required for a complete submission. Understanding these supplementary materials ensures you're well-prepared and helps streamline the process.
Gathering these documents in advance can expedite your claim process. Each document provides vital information that confirms your eligibility for benefits or enhances the efficiency of handling your claim. Always ensure the accuracy and completeness of every form submitted, as this will help in avoiding delays or potential denials of the claim. Remember, the goal is to enable a smooth and swift review of your situation by the reviewing body, ensuring you receive the support you need during your period of disability.
The NJ Family Leave Insurance (FLI) claim form shares similarities with the NJ Temporary Disability form since both are designed to support individuals who are unable to work due to specific personal circumstances. While the Temporary Disability form focuses on those unable to work due to their own disability, the FLI claim form is for those taking time off to care for a sick family member or to bond with a new child. Both forms necessitate information about the claimant's employment, personal identification, and medical certification to process the claim.
Another related form is the Workers' Compensation First Report of Injury. This form is used when an employee gets injured on the job and needs to report the incident to begin receiving workers' compensation benefits. Similar to the Temporary Disability form, it requires detailed information about the injury, employee details, and employment information. However, it specifically focuses on injuries received in the work environment rather than general disabilities.
The Social Security Disability Benefits application form is also aligned with the NJ Temporary Disability form in its purpose of providing financial support. This federal form is used when a person has a disability expected to last at least one year or result in death, significantly affecting their ability to work. Although it serves a similar population, the Social Security disability process involves more stringent eligibility criteria and a broader scope of disabilities nationwide.
The Employment Verification form is critical in many situations, including when filing for disability benefits. This form, which confirms an individual's employment status, salary, and occupational details, is similar to parts of the NJ Temporary Disability form that request employment history and verification from an employer to substantiate a claim for benefits.
The Medical Certification form for FMLA (Family and Medical Leave Act) leave intersects with the NJ Temporary Disability form. Both require a healthcare provider's certification detailing the condition affecting the claimant or their family member. However, the FMLA form is specifically tied to federal leave guarantees rather than state-specific disability benefits.
Lastly, the Request for Federal Income Tax Withholding From Sick Pay form (Form W-4S) is mentioned within the NJ Temporary Disability claim process as an optional attachment. This form allows for the voluntary deduction of federal taxes from disability benefits, similar to how one might elect tax withholdings from a regular paycheck. It connects to the disability claim process by addressing the financial implications of receiving disability benefits.
Filling out the New Jersey Temporary Disability form correctly is crucial to ensure timely processing and to avoid any potential delays or issues with your claim. Here are some essential do's and don'ts to help guide you through the process:
Do:
Don't:
There are several misconceptions about the NJ Temporary Disability form (DS-1) that can lead to confusion for claimants. Understanding these can help in accurately completing and submitting the form.
In truth, you are encouraged to file your claim promptly after stopping work due to disability. Filing before your last day may delay processing.
While it's important to file within 30 days after the disability begins to avoid denial or reduction, benefits may still be granted for late filings if a valid reason is provided.
Actually, claimants do not need a lawyer to appeal a decision, though one may be consulted if desired.
Contrary to this belief, you must inform of any payments you receive, such as sick pay or wages, to avoid potential penalties.
You must comply with requests for continued medical certification (Form P30) by having your physician complete and sign it as necessary.
When you recover or return to work, this must be reported immediately to avoid receiving benefits you are not entitled to.
You must specifically request F.I.T. deductions by attaching Form W-4S to your claim.
If your address changes, notifying the Division immediately in writing is crucial for receiving correspondence and benefits.
For the fastest processing, submit Part A, Part A1, Part B, and Part C together, even if it means reaching out to employers or doctors to complete their sections promptly.
Understanding these nuances of the NJ Temporary Disability form can improve the accuracy and timeliness of claims, helping individuals receive the benefits they need.
Filing the New Jersey Temporary Disability Insurance Claim (Form DS-1) correctly and on time is essential for ensuring the smooth processing of your claim for disability benefits. Here are key takeaways to guide you through the process:
Following these instructions carefully can help ensure that your New Jersey Temporary Disability Insurance claim is processed efficiently and without unnecessary delay. If you require any assistance, do not hesitate to contact the Customer Service Section provided by the Division.
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