On May 2, 2008, the Family Leave Insurance (FLI) was signed into law effective July 1, 2009. In order to obtain a Claim form, please visit the NJ Department of Labor’s Website at www.nj.gov/labor. Once you are directed to the site, click on Family Leave Insurance tab on the left, then click on "Open Claim"
At this point you have the choice to submit your claim online or print out the application and submit a paper application to the State.
When you have completed your part online, please provide Janet Muina in Payroll with the instructions for her to complete the employer portion online with your unique "online claim form ID". You can fax Janet Muina at (732) 914-1607 or email firstname.lastname@example.org. If you fail to do this, your claim may be denied or reduced by the State.
Part D of the Application needs to be sent to the Payroll Department to be completed. It will be returned to you for mailing with your application to the State of New Jersey Division of Temporary Disability Insurance. Please note that claims must be filed within 30 days after the beginning of your family leave or they may be denied or reduced by the State.