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TDI/TCI Quick Reference for Qualified Healthcare Providers (QHPs)
TDI is income support for individuals out of work for non-work related illness or injury; TCI is income support (up to 4 weeks) for individuals out of work to care for seriously ill child, spouse, domestic partner, parent, parent-in-law, or grandparent, or to bond with a new born child, adopted child or foster child. TDI/TCI are financed entirely by payroll deductions.
Qualified Healthcare Providers Defined by law
- Midwives, Nurse Practitioners, Physician Assistants, Physicians, Psychologists and Psychiatric Clinical Nurse Specialists, Licensed Clinical Social Workers-(lCSW) and Licensed Independent Clinical Social Workers-(LICSW) are Qualified Healthcare Providers and can certify as to the inability of individuals to perform their regular or customary work, due to sickness.
Non-Monetary Eligibility Requirement to collect TDI/TCI
- Certification by a Qualified Healthcare Provider (QHP) that an individual is unable to work for at least 7 consecutive days.
About Fraud and Misrepresentation Prevention
- TDI will be working closely with both the Dept. of Health and the Dept. of Labor and Training's Fraud Unit to prevent and detect any potential misuse of program funds. If you suspect and or would like to report fraud, please call (401) 462-1522.
Learn more about TDI/TCI Fraud
Rules of the Road from the RI Dept. of Health Board of Medical Licensure and Discipline
- The Board of Medical Licensure and Discipline worked with state auditors to investigate potential misuse of the TDI evaluation system. A pattern emerged, revealing how some patients have annually received certifications for TDI at times that coincide with traditional seasonal layoffs for certain occupations. Click here to read the brief.
TDI and Workers' Compensation (WC):
- TDI and WC cannot be received for the same weeks
- WC claim must be filed if the illness/injury occurred on the job
- If WC claim is contested, a TDI claim can be filed
- TDI is reimbursed if WC then pays for the weeks TDI has been paid
TDI and Unemployment Insurance (UI):
- TDI and UI cannot be received for the same weeks
- UI must be reimbursed if UI was paid for weeks TDI should have been paid.
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1. What are the medical eligibility requirements for TDI?
To be medically eligible for TDI benefits, a Qualified Healthcare Provider (QHP) must certify the patient functionally unable to perform their customary and regular work duties and provide the length of time the patient is expected to be unable to work.
For eligibility to begin the first day he/she is disabled the patient must have an in-office examination by a licensed QHP that week, the week before or the week after, the disability began. A contact with the QHP via a telephone call is not acceptable by TDI law as a timely examination by a licensed QHP.
Additionally, the patient may be asked to make an appointment with an impartial medical examiner if we believe an exam is necessary. Benefits will be stopped if the claimant does not make or keep the appointment with the impartial medical examiner.
2. My patient is receiving TDI; can I bill TDI for medical expenses?
TDI provides income support to individuals who are out of work because of a non-work related illness or injury. TDI does not pay for medical expenses for the illness or injury.
3. Can I obtain information on my patient's TDI claim?
NO, all information regarding a TDI claim is confidential..
4. What happens when a disability duration exceeds medical guidelines?
When a disability duration exceeds the medical duration guidelines (MDG) the claim is referred to the Claims Management Unit for further review. A Registered Nurse in the Unit will make an additional review of the claim and if necessary, will contact the Qualified Healthcare Provider and/or the TDI customer for additional information.
5. Does TDI have any procedures for preventing fraud and the misuse of benefits?
TDI is very proactive with respect to fraud and the misuse of benefits. By law, TDI can require individuals to be examined by an impartial qualified healthcare provider in order to determine continued disability and eligibility for benefits. The Medical Review Unit refers claims to the TDI Medical Consultant for further review and recommendation as needed. Medical duration guidelines (MDG) are used by the Medical Review Unit to determine disability durations. TDI has an internal program to determine if someone has received TDI benefits during a period when he or she was working. TDI is in constant contact with the Workers' Compensation Court and insurance carriers and with the Unemployment Insurance Division to determine if someone is receiving TDI benefits that he or she is not entitled to.
6. What is an impartial qualified healthcare provider for TDI and how can I become one?
TDI has a database of impartial qualified healthcare providers for all medical specialties, serving the entire state. TDI is constantly seeking to increase the number of impartial qualified healthcare providers in order to better service its customers. If you are interested in becoming an impartial examiner you may contact TDI at (401) 462 - 8381 or e-mail TDI at firstname.lastname@example.org If you prefer, you may write to TDI at Temporary Disability Insurance, P.O. Box 20100, Cranston, Rhode Island 02920-0941.
7. I have a patient who is requesting time out of work to take care of a sick relative and also wishes to apply for TDI; can I certify a person for TDI who is out of work on family medical leave?
NO. TDI only pays benefits to workers who are ill or injured and does not extend benefits to persons taking care of a sick relative while on family medical leave. Advise your patient to apply for Temporary Caregiver Insurance (TCI).
- Provide patient medical reports when requested by TDI
- For TCI, applicants are responsible for obtaining required medical documentation and supporting documents requested by TDI from the care recipient's (seriously ill family member) QHP.
This includes obtaining the care recipient's signature on any QHP required release of information forms. TDI will not be requesting this information directly from the QHP. TDI will provide the claimant with the required form and the claimant will be bringing the form to your office to complete and mail or fax back to TDI to process.
All release of information forms will need to be obtained from the QHP's office directly from the patient.
Become an Impartial Medical Examiner for TDI
Resources + Statistics
Email TDI at DLT.TDI@dlt.ri.gov or call the Qualified Healthcare Providers line at
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