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This document is an application form for Family Leave Insurance benefits. It provides instructions and guidelines for filing a claim, including rules for timely filing, appeal rights, and reporting other payments received. The document also includes sections for bonding certification, medical certificate, and employer's statement. It emphasizes the need for accurate information and provides contact information for claim assistance.

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How do I get my FL3 form in NJ?

If you are approved for Family Leave Insurance benefits but do not initially claim your maximum duration of leave when filing, we will mail you a Continued Claim Certification (FL3), which includes a schedule that you must fill out and sign showing the days you did not work during the period.

What does NJ fli mean on my paycheck?

New Jersey Family Leave Insurance (FLI) is a partial wage-replacement program. It does not guarantee employer-approved time off or job protection.

What qualifies for paid family leave in NJ?

What Circumstances Entitle Me To Take Family Leave? The care of a parent, child under 18, spouse, or civil union partner who has a serious health condition requiring in-patient care, continuing medical treatment or medical supervision.

How do I submit FMLA paperwork in NJ?

You can apply online, which is the easiest way to apply for benefits. You can download, print, and fill out a paper application (FL-1), and mail it back to us at Division of Temporary Disability Family Leave Insurance, P.O. Box 387, Trenton, NJ 08625-0387, or fax it to 609-984-4138.

How much do you get paid for NJ family leave?

Higher benefit amounts for both Family Leave and Temporary Disability: NJ workers can now get up to 85% of their average weekly wage, up to a maximum set per calendar year, to bond with a new child or care for a loved one, as well as for pregnancy, childbirth or a serious health condition.

fl3 form nj pdf

M10 form nj disability pdf NJ Family Leave application online myleavebenefits.nj.gov forms NJ Temporary Disability form online Temporary Disability NJ form Fl2 form NJ family leave insurance continued claim certification (form fl3) Form c10 NJ disability

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How to qualify for FLI in NJ?

In 2025, an eligible employee must work 20 weeks (1,000 hours) to qualify for New Jersey FLI and earn a total of $15,200 during the previous 12 months. Individuals who work in New Jersey and meet all other requirements might be eligible to receive benefits, regardless of where they live.

What is the difference between FMLA and FLA in NJ?

The third major difference between the two acts is that an employee eligible for leave under the FLA is entitled to 12 weeks of leave in any given 24 month period whereas employees eligible for FMLA leave are entitled to 12 weeks of leave during a particular 12 month period of time.

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