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 Application and Download the Application.
Part D of the Application needs to be sent to the Payroll Department to be completed and returned to the employee for mailing with their 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.