New Jersey Temporary Disability Insurance, Benefits

NJ Temporary Disability Insurance: Benefits
at a Glance

Temporary Disability Insurance (TDI) is a required benefit in New Jersey and provides covered employees with up to 26 weeks of partially paid time off due to a non-work-related illness or disability, including mental conditions, as well as childbirth and pregnancy-related complications, such as bedrest.

NJ TDI Maximum Benefit Amount and Duration

The benefit is based on an employee’s average weekly wage, capped at a maximum amount, which is set by the state for each calendar year. TDI benefits pay 85% of the average weekly wage (AWW), capped at 70% of the current State Average Weekly Wage (SAWW).

See the current maximum weekly benefit here.

Maximum length of paid leave

26 WEEKS

Weekly benefit

85%
of AWW,
capped at
70%
of SAWW

Waiting period

7 DAYS*

*The 7-day waiting period is covered after 22 consecutive days of disability; there is no waiting period for organ or bone marrow donations, or COVID-19 related cases.

How to Calculate The Benefit For Temporary Disability Insurance

At time of claim, reported earnings for the 5 completed quarters leading up to the start of the disability are considered for the benefit calculation. The first 4 quarters of this lookback period are considered the base year.

Determine the employee’s average weekly wage (AWW):
- Count back over the last 5 completed quarters (see next section for details on how to count back).
- Select the first 4 quarters (the base year). Add up the earnings over that time period and divide that total amount by the number of weeks worked in the base year. To qualify for TDI, employees must have worked at least 20 weeks during their base year and meet certain minimum gross earnings requirements. Learn more here.
Apply the 85% benefit factor to the employee’s AWW
Check if it falls within the maximum weekly benefit cap:

If 85% of the AWW fall withing the benefit cap, this amount is the weekly benefit. If it exceeds the cap, then the weekly benefit is the cap. The maximum weekly benefit cap usually gets adjusted every year. See the current cap here.

How to Calculate The Base Year and Minimum Gross Earnings Requirements for NJ TDI

As mentioned above, the first 4 quarters of the lookback period are considered the base year, and employees must have worked at least 20 weeks during that period. To determine the base year earnings, count back by 5 completed quarters from the date the claim began to the prior 4 out of 5 completed quarters. Here is a handy chart to identify the 4 quarters based on the claim filing date:

If the claim began in. . .	. . . you would use the Average Weekly Wage from this period:
Q1 (Jan. 01 - Mar. 31)	October 1 from 2 years ago to September 30 of prior year
Q2 (Apr. 01 - Jun. 30)	January 1 to December 31 of prior year
Q3 (Jul. 01 - Sep. 30)	April 1 of prior year to March 31 of current year
Q4 (Oct. 01 - Dec. 31)	July 1 of prior year to June 30 of current year

Minimum Gross Earnings Requirements:

Aside from the 20-base week minimum, employees also need to meet certain minimum gross earnings requirements, which usually change on an annual basis. Visit New Jersey’s program page for the current earnings requirements.

Tip: If the TDI coverage is through ShelterPoint¹ and the employee doesn’t have a standard base year, please let us know. We may be able to use an alternate method of calculating the base year earnings.

TDI Frequently Asked Questions

What if the benefits were filed late?

There is a 30-day timeframe to file a claim once an employee is out on temporary disability. Thereafter, a valid reason for filing late is needed – but the benefit may be reduced or denied.

How does the 7-Day Waiting Period work?

During the first week an employee is out due to a qualified condition, they don’t receive benefits – unless the disability extends through more than 22 days, in which case they may receive a retro payment for the first 7 days.
Additionally, if the employee applied for disability due to an organ or bone marrow donation, the waiting period is waived, i.e., benefits would begin from day 1.

Is TDI only for residents of New Jersey?

No, the rule of thumb is that employees have to work in New Jersey to qualify for TDI benefits. So, it’s based on where someone works, not lives.

Does Temporary Disability Insurance provide job protection or anti-retaliatory provisions?

While TDI doesn’t provide job protection, employees may have job protection under the federal Family Medical Leave Act (FMLA).

Is pregnancy covered under Temporary Disability Insurance?

Yes, but the doctor will be required to certify that the employee is disabled and unable to work due to her pregnancy. Usually, the birth mother may receive benefits up to 4 weeks before the expected date of delivery, and 6 to 8 weeks after childbirth, depending on how the baby is delivered. The doctor would need to certify that there were complications more than 4 weeks before the expected delivery date or longer than 8 weeks after childbirth to request benefits for a longer period of time.

How do you file a COVID-19 claim?

If ShelterPoint provides the TDI benefits, follow the steps outlined in the next question and download the NJ TDI claim form here or right below in the Download Center module on this page. The healthcare provider needs to complete Part B (Medical Certificate); the employer needs to complete Part C.
If the state provides TDI benefits, please visit the state’s TDI webpage.
If another approved Private Plan provides the TDI benefits, please reach out the other insurance carrier who provides the coverage.

ShelterPoint provides Temporary Disability Insurance benefits at our business. Where do we file a claim?

There are 4 ways you can file a claim with ShelterPoint Life Insurance Company:

By email:
claims@shelterpoint.com
By mail:
ShelterPoint Life Insurance Company
Attn: NJ TDI Claims
1225 Franklin Avenue, Suite 475
Garden City, NY 11530
By fax:
Fax 516-504-6414
By upload of the claim package directly on our website
Please send your completed claim package through one method only once, or it will be separated from processing to determine which package you submitted is the most complete, which may delay your claim.

NJ Temporary Disability Insurance Download Center

Looking for a TDI-related form, whether application or claim?

Visit our Download Center for forms such as the DP-1 Application form or Temporary Disability Claim Form.

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*The ShelterPoint family of companies operates under the “ShelterPoint” name strictly as a marketing name, and no legal significance is expressed or implied. The ShelterPoint family of companies consists of ShelterPoint Life Insurance Company (principal office in Garden City, NY) and its wholly-owned subsidiary ShelterPoint Insurance Company, a FL-domiciled carrier, depending on the state. ShelterPoint is a registered service mark.

This material is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice. Any program information is based on our knowledge and understanding of NJ’s applicable laws and regulations as of the publication date and may change as regulations evolve or NJ issues updated guidance. Further, this material is for illustrative purposes only, providing a general overview of the services described. It is not a contract nor intended as an offer of coverage.

Policies are subject to Underwriting approval. Policies are reviewed annually and may be cancelled for nonpayment. All coverage extends to limits reflected in the policy. Please refer to the policy for coverage details pursuant to its governing law, including a complete listing of covered services, provisions, conditions, exclusions, limitations, and terms under which the policy may be continued or cancelled. In the event of conflicting information with the policy and its governing Law, the policy and governing Law will take precedence over what is shown in this material. Claim payment is not guaranteed; benefit amount depends on wages.

The Temporary Disability Benefits (TDB) Law (P.L.1948, c.110 (C:43-21-25 et seq.)) and applicable Administrative Code (N.J.A.C. 12:18-1 et seq.) govern this Private Plan and its interpretation and administration. Available in NJ only. Policies have a statutory 7-day waiting period.

Underwritten by: ShelterPoint Life Insurance Company (principal office in Garden City, NY) in: NJ (form# TDB-P-NJ)

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All policies are underwritten and administered by either ShelterPoint Life Insurance Company (principal office in Garden City, NY), or ShelterPoint Insurance Company, a FL-domiciled carrier, depending on the state. Contact Underwriting for details.
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NJ Temporary Disability Insurance:Benefits

NJ Temporary Disability Insurance: Benefitsat a Glance