XL LG MD SM XS

Division of Temporary Disability and Family Leave InsuranceURL reading ( My Leave Benefits . NJ . Gov )

Send Us a Message

A woman's hands typing on a computer keyboard

Use this online form to ask questions about our programs or about a current claim. Fill it out as completely as possible so that we can respond more accurately to your questions. We will respond as soon as possible by email. Remember, if you have a current claim, you can also obtain information using our online system.

If you are a healthcare provider or employer, we cannot reveal specific information about a claim without the written consent of the claimant.

**
**
**
**
**
**
**
**
**
**
**
**
**

(** indicates a required field)

Related Topics
A man sitting at his desk opening a letter, looking confused

Did you get a form or notice from us in the mail but aren't sure what it means? 

LEARN MORE >

Hand holding a debit card while looking at a smartphone

We issue benefits on a prepaid debit card instead of paper checks.

LEARN MORE >