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

How to Submit Wage Information

Restaurant manager in the back office doing paperwork, and smiling

We need wage information to process benefit applications for both Temporary Disability Insurance and Family Leave Insurance.

Your employees are responsible for giving you any employer forms that need to be completed. However, we can’t quickly process your employees’ applications for benefits without receiving accurate wage information from you in a timely manner.

Submitting Wage Information Online
If your employees apply online for benefits, you’ll also be able to submit wage information online using the printed instructions (form E0-1) and unique form identification number they’ll give you.

Submitting Wage Information by Mail or Fax
For paper applications, your employees will give you part C of the DS-1/Application for Temporary Disability Insurance benefits, or part D of the FL-1/ Application for Family Leave Insurance benefits. That Employer Statement should be returned with the employee’s original application, not separately. The Employer Statement is used to confirm the information the employee supplies in part A of the application. Remember, applications for benefits cannot be submitted before the employee’s leave begins, so do not post-date your statement.

An Additional Layer of Verification
We also check applications against the wage record maintained by the Division of Employer Accounts to make sure all employers and wages are accounted for. Even if an employee does not list you on his or her application, we will send you a wage report request (form E-20) if we find that he or she was paid wages by your business at any time during the base year (52 weeks immediately before the week in which the disability began). If the application for benefits, including your Employer Statement, is completed before your employee stops working, we will also send you form E-20 to reconfirm the information.

Be Prompt to Avoid Fines
You are required by law to supply the requested wage information. If you do not comply within 10 days from the date of mailing, a $250 penalty will be assessed by the Division. If you receive a wage request for someone who is not or was not your employee, note that on the form and return it to our office promptly to avoid the penalty.

Helpful Tips

  1. If you receive a paper wage report request (Form E-20):
    1. Complete and return the form within 10 days from the date of mailing to avoid penalties.
    2. Include the employee's Social Security number on all pages.
    3. Complete both sides. Date and sign the form and include a telephone number where you can be reached. Do not post-date the form.
  2. Verify the claimant's Social Security number with your records.
  3. Give exact dates. The last day worked is particularly important. Remember, this is the last day the employee physically worked, not the last day the employee received compensation (wages, paid sick time, etc.), or the end date of that pay period.
  4. If you paid the applicant any money during the disability period, provide the exact beginning and ending dates for which the payment was allocated (not necessarily the pay period dates), the gross amount, and the type of continued pay (sick pay, vacation pay, etc.).
  5. All money amounts should be gross figures. Wages should include tips, overtime, and commission.
  6. Use Saturday week-ending dates when listing weekly wages for the 10 weeks prior to the disability date.
  7. If you need to include additional information, attach a note to your form.
  8. If a form was mailed to an incorrect address, update the address when you return the form.

For more information, please contact us.