Before filing a claim you will need to have the following information available:
Your Social Security Number.
The full names, addresses and phone numbers of all Qualified Healthcare Providers(QHP) who are treating you for this disability.
New as of 12/1/2014: The medical certification form (TDI-3 or TDI-3C) will be mailed directly to your address on record when your claim is processed in our system, within 7-10 days from date of filing. It will be your responsibility to deliver the required medical certification form to the appropriate Qualified Healthcare Provider (QHP) or physician that is treating you. It is your responsibility to complete any release of information form your QHP may require. Please have the QHP complete and return the medical certification form to our department within 10 days as instructed on the form.
The names, complete addresses, phone numbers and dates of employment for all your employers for the last 24 months.
Social Security numbers for any dependent children who are 12 months of age or older.
Direct Deposit information; bank name, account number and bank routing number if you wish to have your benefits directly deposited into your bank.
If you are filing for the Temporary Caregiver Insurance Program, you will also need the following information:
- Person's name, address, phone number, and date of birth you will be caring for
- Relationship to you
- Bonding Child's legal name, date of birth, and social security number for children who are 12 months of age or older
If this is a work-related disability, it will be helpful to provide the following information when filing your claim.
Your employer’s Workers' Compensation Insurance carrier.
Your attorney’s name, address and phone number, if you have one representing you in this matter
Your Workers' Compensation Petition number.
Information Regarding the Temporary Caregiver Insurance Program (TCI)
TCI applications must be received by the department within 30 days from the first day your leave was taken. If the application is not received within 30 days, the claim will be denied.
It is required by law that you notify your employer(s) in writing with a minimum of thirty (30) days notice prior to the first day of the family leave.
Temporary Caregiver Insurance Program benefits are subject to income tax and to rules that apply to reporting of income and payment of taxes. Following the end of each calendar year, you will be mailed, to the address on our records, a statement (Form 1099-G) of the total amount of benefits you received during the year.
If you return to work during the period for which you claimed benefit payments under this program, you must report this date immediately to TDI.
If your mailing address changes, you must notify TDI immediately in writing, please include your name, last 4 digits of your social security number and signature.
Warning: Unless you receive a confirmation number, your claim will not be processed. The Rhode Island Department of Labor and Training will not retain any of the information you enter to file your claim until you receive your confirmation number.
The last page of the Internet application will state that your claim has been completed and will give you a confirmation number. You may then exit without losing any information.
If you wish to terminate filing your Temporary Disability Insurance claim now, or at any time during filing, please select the “Exit” link at the top of the screen. If you exit the application before receiving a confirmation number, any information that you have entered will be discarded.
To initiate an electronic Temporary Disability Insurance benefits claim, please select the “File a Claim” button below: