New Jersey’s FL3 continued claim form is the certification the Division of Temporary Disability and Family Leave Insurance mails you when you were approved for Family Leave Insurance (FLI) but didn’t claim your full allotment of leave up front. To keep your benefits moving, complete the worker certification, fill in the leave schedule on the reverse, have the care recipient’s healthcare provider sign the medical certification if it’s a caregiving claim, and return the form by mail or fax. Payments pause until the Division has it in hand, so speed matters.1My Leave Benefits. Family Leave Insurance
Why You Received an FL3
The FL3 is not the initial FLI application. You already filed that online, by mail, or by fax, and the Division approved it. Because you didn’t request the maximum benefit duration at the start, or because you’re taking leave intermittently, the Division needs you to document the specific days you were out before it releases more payments. You’ll get a new FL3 to complete after each period of leave.1My Leave Benefits. Family Leave Insurance
The form is used for both caregiving claims (caring for a seriously ill family member) and bonding claims (time with a newborn, newly adopted, or newly placed foster child). The only part that differs between the two is the medical certification section.
Completing the Worker Certification
This is your portion of the form. You confirm your identity, enter the date through which you want to receive benefits, and sign. Check that your Social Security number and contact information match what’s on file, since the Division uses those details to link the FL3 back to your existing approved claim.2Division of Temporary Disability and Family Leave Insurance. Why Did I Get This – Form Look Up A mismatch here can stall processing even when the rest of the form is perfect.
Filling In the Leave Schedule
The reverse of the FL3 has a schedule where you list the days you didn’t work and want to claim benefits for. Each row starts with a Week Beginning Date, which should be the Sunday of the week you took leave.
Mark only the days you were actually out providing care or bonding. Do not mark:
- Days you worked
- Weekends or other days you wouldn’t have been scheduled anyway
- Holidays your employer already paid you for
Schedule errors are the most common reason the Division sends an FL3 back for correction.2Division of Temporary Disability and Family Leave Insurance. Why Did I Get This – Form Look Up Take a minute to check the calendar week by week before you sign.
Medical Certification for Caregiving Claims
If your leave is to care for a seriously ill family member, the care recipient’s healthcare provider must complete the medical certification section of the FL3. The provider confirms that the family member’s condition still requires your care and updates the expected duration.
For bonding claims, this section does not apply and you can skip it.2Division of Temporary Disability and Family Leave Insurance. Why Did I Get This – Form Look Up Get the provider’s signature before you send the form in. An unsigned medical certification will be rejected, and chasing a doctor’s office for a signature is often what causes the biggest delays in reaching your next payment, so start that request early.
Where to Send the FL3
Once every applicable section is complete and signed, submit the FL3 to the Division by mail or fax:
- Mail: Division of Temporary Disability Insurance, PO Box 387, Trenton, NJ 08625-0387
- Fax: (609) 984-4138
The Division asks you to allow 14 days of processing time before inquiring about your continued claim.3New Jersey Department of Labor and Workforce Development. Division of Temporary Disability Insurance Application for Family Leave Insurance Benefits Keep a copy of the completed form and, if you fax it, the transmission confirmation.
What Happens After You Submit
If the Division needs additional information, it will contact you by mail or through your online dashboard. Your benefit payments stay on hold until the FL3 clears processing, so watch for messages and respond quickly. Payments are issued through the state-issued debit card or by direct deposit, depending on the selection you made when you filed the initial claim.
Remember that you’ll go through this process again if you take another block of leave. Each period of leave completed generates a new FL3, and each one has to be returned before benefits for those days are released.1My Leave Benefits. Family Leave Insurance
Common Reasons an FL3 Gets Sent Back
A few problems account for most of the delays workers run into:
- The leave schedule includes days the worker actually worked, or weekends and paid holidays
- Personal information on the form doesn’t match what the Division has on file
- The medical certification section is blank, incomplete, or unsigned on a caregiving claim
- The worker signature line is missing
Each of these restarts the clock on your next payment. Reviewing the form one more time before dropping it in the mail is worth the few minutes.
If Your Continued Claim Is Denied
If the Division denies your continued claim certification, you have 21 calendar days from the mailing date of the denial notice to file an appeal with the Appeal Tribunal.4Division of Temporary Disability and Family Leave Insurance. Appealing a Decision A hearing examiner reviews the evidence and issues a decision. If you lose there, the next level is the Board of Review, which must receive a written appeal within 20 days of the Appeal Tribunal decision and generally decides on the existing record rather than holding a new hearing.5My Unemployment NJ. About the Board of Review Because the Board rarely takes new testimony, a well-argued written submission carries the case.