RI.gov    R.I. Government Agencies | Privacy Policy |
     RI DLT, Temporary Disability Insurance~Temporary Caregiver Insurance
  • DLT
  • Labor Market Information
  • Temporary Disability
  • Unemployment Insurance
  • Workers' Compensation
  • Workforce Development
  • Workforce Regulation and Safety
DLT homeAbout DLTOnline NewsroomSitemapRules and RegsPublicationsFormsDirectionsContact DLT
LMI HomeData CenterLMI for JobseekersLMI for BusinessLMI PublicationsWagesLicensed OccupationsLMI News ReleasesFAQsContact LMI
TDI homeFile a TDI ClaimElectronic Payment CardQualified Healthcare ProvidersTDI for employersTDI FormsTDI FAQsContact TDI
UI homeFile a UI ClaimAccess AccountTeleserveElectronic Payment CardsUI for EmployersExtended BenefitsUI FAQsContact UI
WC HomeEducationDonley CenterInjured WorkerEmployerInsurer/AdjusterIndependent ContractorFormsFAQ'sContact WC
WFDS HomenetWORKriBusiness ServicesGovernor's Workforce BoardWorkforce Investment OfficeTradeYouthVeteransContact WFDS
WRS HomeProfessional RegulationApprenticeshipPrevailing WageLabor StandardsOccupational SafetyPublications and FormsContact WRS

TDI Online Application
Printable Application
Check Status of TDI Claim

Direct Deposit
Avoiding EPC Fees

Partial Return-to-Work
TDI for Veterans
Frequent Questions



Application for TDI/TCI Benefits Form

Please note a NEW****process as of 12-1-14, all TDI medical forms will be mailed to your home address. It is your responsibility to provide the required medical form (TDI-3 or TDI-3C) to your Qualified Healthcare Provider (physician) for completion.  

Click here to download the "paper" application form for TDI benefits
You will need Adobe Reader to access the application. Get Adobe Reader

Click here to access information on Direct Deposit


Please complete every question so that you will not experience delays in filing for benefits. Please do not file multiple applications for the same illness/injury as this will also delay processing your claim.

Please print and complete the application form. Attach the direct deposit form (if you choose that option) and mail to:

Temporary Disability Insurance
P.O. Box 20100, Cranston, RI 02920-0941


We have eliminated the payment of TDI benefits by paper checks. You have two different benefit payment options; Direct Deposit or Electronic Payment Card (EPC) (similar to a debit card).

  • If you select the Direct Deposit method, please complete the direct deposit form and mail it with your TDI application to the address below.
  • If you select the Electronic Payment Card (EPC), do not send in a direct deposit form. The EPC card will arrive in the mail in a plain white envelope. Please be sure to read the instructions to avoid any ATM or bank charges. Visit the TDI EPC website for more information.
 

 
RI Department of Labor and Training
Temporary Disability Insurance
P.O. Box 20100,
Cranston, RI 02920
-0941

Phone: (401) 462-8420
Fax (401) 462-8466
TTY via RI Relay: 711
12/8/14 MDF
State Seal
  DLT is an equal opportunity employer/program. Auxiliary aids and services available upon request