The NJ FL3 form, formally the “Request to Claimant for Continued Claim Information,” is a certification the New Jersey Division of Temporary Disability and Family Leave Insurance mails to Family Leave Insurance claimants whose approved leave period is ending but who did not originally claim the full duration available.1My Leave Benefits. Family Leave Insurance You write in the days you did not work, sign the schedule, and send it back. Without it, the Division cannot release your next payment, so treat it as a deadline the moment it arrives.
Why the Division Sent You an FL3
The FL3 goes out after your initial FLI claim has been approved, once the period covered by your original application is running out and you still have leave left on the calendar.1My Leave Benefits. Family Leave Insurance Family Leave Insurance covers up to 12 weeks of continuous leave in a 12-month period, or up to 56 individual days if you are taking leave intermittently.2Division of Temporary Disability and Family Leave Insurance. Family Leave Insurance FAQ The FL3 is how the state confirms you actually took the days you are now claiming before it authorizes the next round of benefits.
One boundary worth flagging: the FL3 is a Family Leave Insurance form. If you are on Temporary Disability Insurance instead, the Division uses a different continued-claim process, and the healthcare provider who certified your condition drives how long benefits run, up to 26 weeks.3Division of Temporary Disability and Family Leave Insurance. When You’re Sick, Injured, or Post-Surgery Check your decision notice for the exact form the Division wants from you.
What to Have in Front of You Before You Fill It Out
The FL3 is shorter and simpler than the initial application. The core of it is a schedule listing the specific days during the period that you did not work, followed by your signature certifying the schedule is accurate.1My Leave Benefits. Family Leave Insurance
Before you start writing in dates, pull together:
- Your Claim ID from the original decision notice.
- Your Social Security number, which the Division uses to match the form to your file.
- A precise record of your work schedule for the period. If your leave was intermittent, this is where mistakes turn into problems: a day you actually worked, reported as a leave day, can trigger an overpayment review.
Cross-check the dates against your own calendar and, if you can, against what your employer has on file. Mismatches are one of the most common reasons the next payment stalls.
How to Submit the FL3
You have three options. The Division itself points to online submission as the fastest route.1My Leave Benefits. Family Leave Insurance Log into your account at myleavebenefits.nj.gov, upload the completed FL3, and save the confirmation the system generates.
To mail a paper copy, send it to:
Division of Temporary Disability and Family Leave Insurance
PO Box 387
Trenton, New Jersey 08625-03874Division of Temporary Disability and Family Leave Insurance. Contact Us
To fax it, use (609) 984-4138.5New Jersey Department of Labor and Workforce Development. Division of Temporary Disability Insurance Application Keep the transmission confirmation. Whichever route you use, return the form as soon as the schedule period is complete. Every day you sit on it is a day added to the gap before your next payment.
What Happens After You Send It In
The Division works through claims in the order it receives them.3Division of Temporary Disability and Family Leave Insurance. When You’re Sick, Injured, or Post-Surgery There is no separately posted turnaround time for the FL3, but the Division’s general guidance on disability applications asks that you wait at least 14 days before calling to check on a claim.6Division of Temporary Disability Insurance. Claim for Disability Benefits DS-1 A continued-claim certification is normally lighter work than a new application, but plan on a similar window.
Reviewers compare the days you listed against any employer records already on file and confirm you have not passed your maximum benefit entitlement. If a reported leave day overlaps with reported wages or something else does not line up, the Division may ask you to clarify before releasing the next payment. You can watch the status through the MyLeaveBenefits portal or by contacting the Division directly.
How the Continued Payments Reach You
Approved payments load onto a prepaid Visa debit card issued by Money Network/My Banking Direct, which arrives in a plain envelope with an Omaha, Nebraska return address.7Division of Temporary Disability and Family Leave Insurance. Debit Card Information If a card was already issued for your initial claim, the continued payments go to that same card. No second card is mailed.
Direct deposit is not offered to most claimants. The narrow exception: if you were receiving Unemployment Insurance by direct deposit within the 28 days before your family leave claim, that arrangement carries over.7Division of Temporary Disability and Family Leave Insurance. Debit Card Information Otherwise, expect the card.
The FL3 does not change your weekly benefit amount. Your rate was locked in when the claim was first approved at 85% of your average weekly wage, subject to an annual maximum equal to 70% of the statewide average weekly wage.8NJ Department of Labor and Workforce Development. Temporary Disability and Family Leave Insurance The form only extends the period over which that rate is paid.
Reporting Days Accurately
Only list days you genuinely did not work. Under New Jersey law, anyone who knowingly makes a false statement or conceals a material fact to obtain benefits is subject to a fine equal to 25% of the amount fraudulently obtained, and each false statement counts as a separate offense.9Justia Law. New Jersey Revised Statutes Section 43-21-16 Beyond the fine, the Division will recover any benefits you were not entitled to, and it can offset future payments or collect through the courts.
If you notice a mistake after submitting, contact the Division right away to correct the record. Fixing it yourself is always better than having it flagged in an audit.
If Your Continued Claim Is Denied
Every decision notice from the Division includes appeal instructions, and you should follow the ones on your specific notice.3Division of Temporary Disability and Family Leave Insurance. When You’re Sick, Injured, or Post-Surgery For claims handled under a private employer plan, appeals go in writing to:
Division of Temporary Disability Insurance
Private Plan Operations
Claims Review Unit
P.O. Box 957
Trenton, NJ 08625-0957
Fax: (609) 292-25373Division of Temporary Disability and Family Leave Insurance. When You’re Sick, Injured, or Post-Surgery
Appeals can also be submitted online through the MyLeaveBenefits portal. Private plan disputes carry a one-year deadline from the date your disability began. Do not wait out that clock. Gather your documentation and file as soon as you get an unfavorable decision.