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Department of Labor and Workforce Development Forms - NJ.gov 2026

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  1. Click ‘Get Form’ to open the Claim for Disability Benefits (DS-1) in the editor.
  2. Begin by completing Part A. Fill in your full name, birth date, and Social Security Number clearly to avoid processing delays.
  3. Provide your home address and mailing address if different. Ensure all information is accurate, especially your contact details.
  4. In Items 12-15, include exact dates related to your disability and any emergency room care received. This information is crucial for your claim.
  5. Complete Part A1 by designating a representative if needed, signing the form, and including your phone number for follow-up.
  6. Ensure Parts B and C are completed by your doctor and employer respectively. Missing parts can delay your claim significantly.
  7. Review all entries for accuracy before submitting. Use our platform’s features to save a copy of the completed form for your records.

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BC-2, Request for Wage Separation Information If any of your employees or former employees apply for Unemployment Insurance benefits, well send this form to you. The information you provide will help us determine whether or not they are eligible for benefits.
PUA recipients may also be eligible for an extra $300 per week from January 2021 to the week ending September 4, 2021 through Federal Pandemic Unemployment Compensation (FPUC), which is also taxable.
We will calculate your weekly benefit rate at 60% of the average weekly wage you earned during the base year, up to that maximum. We determine the average weekly wage based on wage information your employer(s) report.
The weekly benefit amount in California is calculated via a benefits chart based on your earnings in the highest quarter of the past four quarters. The minimum weekly benefit amount a Californian could receive is $40 and the maximum is $450.
The Federal Pandemic Unemployment Compensation (FPUC) program added a weekly supplement of $600 to the amount individuals received in state unemployment. This supplement was later reduced to $300.

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