New Jersey Temporary Disability: Fax Number for Claims

What is the fax number for New Jersey Temporary Disability claims?

New Jersey's Division of Temporary Disability and Family Leave Insurance confirms directly on its own official FAQ page that a claimant can "download, print, and fill out a paper application (DS-1)... or fax it to 609-984-4138." This is the claimant-facing paper application route.

Where to fax

• Paper DS-1 application for the state plan: fax 609-984-4138. Source: New Jersey's official Temporary Disability Insurance FAQ.

^{Fax number verified October 19, 2026.}

Which route should I use?

Start by asking your employer whether you have state-plan or approved private-plan coverage. If you have a private plan, ask HR how to submit your claim to the carrier. New Jersey warns that sending a private-plan application to the state can add four to five weeks while it is forwarded.

For a state-plan claim, you can apply online or send the paper DS-1 by fax to 609-984-4138. Mail is also accepted at Division of Temporary Disability Insurance, P.O. Box 387, Trenton, NJ 08625-0387.

Choose one submission method. The DS-1 instructions warn that duplicate applications delay processing. If you've already applied online, don't also fax or mail the same application.

Before you fax the DS-1

Download the DS-1 linked by New Jersey's official FAQ, then check these details:

• Complete Parts A and B yourself. Have your healthcare provider complete and sign Part C, the medical certificate.
• Give exact employment dates, including the last day you physically worked before your disability. Part B asks about every employer in the six months before your leave; copy that page if you need more room.
• Sign and date your part of the application. Check that the provider's section is complete too.
• Follow the form's instructions to include your name and Social Security number on each page and attachment. Double-check the destination before sending personal or medical information.

Keep a copy of the completed application and your fax transmission report.

Filing in a different state? See how to fax the Texas DWC or the Ohio BWC fax page for that state's confirmed routing.