Disability Insurance/Temporary Caregiver Insurance
Frequently Asked Question
on each question to show the answer.
What is the Temporary Caregiver Insurance (TCI) Program?
- The Temporary Caregiver Insurance Program was signed into law and will become effective as of January 5, 2014. Individuals may apply for benefits as of January 5, 2014. An individual may receive up to a max. of 4 weeks of TCI benefits (which will reduce the max. weeks of TDI) during a Benefit Year Period:
A. To care for a for a seriously ill child, parent, spouse, domestic partner, parent-in-law, or grandparent………or
B. To Bond with a newborn child, adopted child or foster-care child (available during the first 12 months of parenting only)
Monetary eligibility is determined the same as for TDI benefits.
Caregiver Claims: the claimant is responsible to obtain the medical documentation necessary.
Bonding Claims: the claimant is responsible to provide proof of child/parenting relationship.
- 2. Can I File My TDI/TCI Claim Ahead of Time?
- You may not file your claim ahead of time. A TDI/TCI claim cannot be entered into the system until you are unemployed due to an illness/injury, caregiver/bonding. If you file a claim ahead of time, the claim will be sent back to you (paper application) or cancelled (internet application).
- 3. When should I apply for TCI benefits?
- You must apply for TCI benefits during the first thirty (30) days after the first day of leave is taken for reasons of Bonding or Caregiver. Please refer to Rule 37-B(1) of the RI Department of Labor and Training Rules for the Unemployment Insurance and Temporary Disability Programs.
If you are currently in receipt of TDI benefits, you must first be released from your doctor as “fully recuperated” prior to submitting your application for TCI for bonding or cargiving benefit payments.
- 4. When and how can I apply for TDI/TCI
- By accessing the TDI website at www.dlt.ri.gov/tdi, you may apply online or download an application to complete and mail to TDI, P.O. Box 20100, Cranston, RI 02920. You may also call (401) 462-8420 AFTER 4pm and choose option 1. An application will be mailed to you. If you become ill or injured, and an examination by a Qualified Healthcare Provider (QHP) indicates that you cannot work for at least 7 consecutive days, your claim should be filed as soon as possible to avoid jeopardizing or delaying your first payment. Claims must be filed within 90 days of the 1st week out of work due to illness.
- 5. Who
can I call if I have questions about my TDI/TCI Claim?
- You can call (401) 462-8420 and get up-to date claims information from our voice response system. You may call between 8 AM and 3:50 PM Monday, Tuesday and Thursday and 8:00 AM to 11:50 AM Wednesday and between 9:00 AM and 3:50 PM on Friday to speak with a customer service representative. You must provide your entire claim and personal identification (PIN) numbers when you call.
- 6. Can I add an additional week(s) to my current TCI claim if I need more time for caregiving or to bond with my child?
- No, your claim is processed based on the number of weeks and dates you requested on your initial application. If you have not reached the maximum allowance of 4 weeks (within the same claim year) you may file another claim as long as you are out of work for at least seven (7) consecutive days (after the original claim ended).
are my benefit payment options? Can I still get
- NO. The RI Department of Labor and Training will no longer issue
checks. Payments are made through Direct Deposit or Electronic
Deposit: To choose Direct Deposit to your checking or savings
account, you must complete the Direct Deposit application form.
To obtain a form, call (401)462-8420 or download the application
form from this site: www.dlt.ri.gov/tdi,
then complete and mail it to TDI, P.O. Box 20070, Cranston,
Payment Card: If you do not select direct deposit, you
will automatically be sent an electronic payment card, which
works like a debit card. For detailed information on the electronic
payment card, visit www.dlt.ri.gov/tdi.
8. How do I report my Return to Work date or Recovered from illness date?
- You may contact the automated system by calling 401-462-8700, no waiting required. Follow the instructions and enter you claim number and your claim’s PIN number. The first question will ask you for your return to work or recuperation date. When you enter the date, the system will post it automatically to your claim. Or you may complete and mail to our department the “Return to Work” form previously sent to you with your claim’s computation statement. Or you may simply mail us a letter/note with your information providing your return to work or recuperation date. Or you may contact TDI’s Customer Service Unit by calling 401-462-8420 and speak with a representative. Or you may send us an email at DLT.TDI@dlt.ri.gov with your information and exact date that you returned to work.
What is my claim Number? What is my PIN?
claim number is your 9 digit Social Security Number (SSN) plus
the 3 or 4 digits following it, which signify your benefit year
ending date and record number. For security purposes only the
last 4 digits of your SSN plus the digits following it are included
on forms we send to you.
Your PIN number is on the Notice of Claim Received form that is sent to
you when your application is received.
What are the medical requirements for TDI?
- To be medically eligible for TDI benefits, a Qualified Healthcare Provider (QHP) or medical practitioner must certify you as unable to perform your customary and regular work duties. Your QHP will inform our department (via the TDI form) the length of time you will need to recuperate and unable to work.
For your eligibility to begin the first day you were disabled you must have an in-office examination by a licensed Qualified Healthcare Provider (QHP) that week, the week before or the week after, your 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, you may be asked to make an appointment with an impartial medical examiner if we believe an exam is necessary. Your benefits will be stopped if you do not make or keep the appointment with the impartial medical examiner.
What Is A Qualified Healthcare Provider?
- Qualified Healthcare Provider (QHP) means an individual licensed in the United States of America to practice medicine, surgery, dentistry, optometry, osteopathy and podiatry; also chiropractic and psychology within the scope of the individual’s practice as defined by applicable laws of Rhode Island, or of any other state of the United States. This includes, licensed clinical social workers, licensed independent clinical social workers, licensed midwives, nurse practitioners, physician assistants and psychiatric clinical nurse specialists (PCNS).
What are the earnings requirements for TDI and TCI?
- To be eligible for TDI & TCI benefits, you must have earned wages in Rhode Island and paid into the TDI/TCI fund and for claims filed effective 1-3-16 you must have been paid at least $11,520 in either your Base Period or an Alternate Base Period (both are explained in the following sections). If you did not earn this amount, you may be eligible if you meet all of the following conditions:
1. You earned at least $1,920 in one of your base period quarters,
2. Your total base period taxable wages are at least one and one-half times your highest quarter of earnings, and
3. Your base period taxable wages equal at least $3,840.
When will benefits be deposited in my account?
benefits will be deposited within 48 hours of approval by the
Department of Labor & Training. Approval is based on monetary
eligibility and medical certification from your Qualified Health
Care Provider. You should always check your balance before using
the card. You may conduct balance inquiries free of charge through
the convenience of Internet access at www.myaccount.chase.com
OR you can call Chase Customer Service toll-free number
What is the base period?
- The base period is the period of time we use to determine if you have sufficient wages to be eligible. The base period is the first four of the last five completed calendar quarters before the starting date of your new claim. The calendar quarters are: Jan 1-March 31; April 1-June 30; July 1-Sept 30; and Oct 1-Dec 31. Once a quarter's wages are used to establish a claim, they cannot be used again on a later claim.
What is an alternate base period?
you are not eligible using your base period earnings, we will
recompute your claim using an alternate base period. The alternate
base period is the last four completed calendar quarters before
the starting date of your claim. While you must still meet the
same earnings requirements, this allows some of your more recent
wages to be used.
When does my claim begin?
- Your new claim begins with the Sunday of the week in which you became unable to work. The Benefit Year is a 52-week period which begins on the Sunday of the week in which your unable to work date occurs. New claims filed with the effective date of 7-1-12 or later, that has met all other eligibility criteria, are provided benefit payments as of the first day of unemployment due to the illness/injury and as of 1-5-14 due to caregiver/bonding. Any additional claims (refiles) you submit during this period will have the same benefit year..
When will I get my first payment?
- Most eligible customers get their first payment within 3-4 weeks from the day TDI receives the application. Missing, or wrong information may delay payment.
Do TDI or TCI claims require a non-paid Waiting Period?
- No, due to a legislative approved change, claims filed effective 7-1-12 or later no longer need to serve a non-paid waiting period. However, to be eligible for benefits an individual must still be certified by a Qualified Healthcare Provider out of work for 7 consecutive days or more due to an illness or injury. Caregiver/bonding claims must be out of work for 7 consecutive days as one of the eligibility requirements.
How long do I have to be out of work to file a TDI or TCI claim?
- When filing a new claim or refile on a current claim an individual must be unemployed due to sickness or non-work related injury for at least seven (7) consecutive days in order to be eligible for TDI or TCI benefits.
How much will I receive in benefit payments? How much will I receive for dependency allowance ?
- Your weekly benefit rate will be equal to 4.62% of the wages paid to you in the highest quarter of your Base Period. Your weekly benefit rate remains the same throughout your benefit year. Claims with a Benefit Year Begin Date effective 7-3-16 or later $817.00 is the maximum benefit rate and effective 1-3-16 the minimum benefit rate is $89.00. This does not include dependency allowance.
If you have dependent children less than 18 years of age, you may be entitled to a dependency allowance. Incapacitated children over 18 may also be counted toward the dependency allowance. The dependency allowance is limited to 5 dependents and is equal to the greater of $10 or 7% of your benefit rate. Your dependency allowance is determined at the start of your benefit year and remains the same for the entire period.
Why is my TDI/TCI payment less than my full benefit amount?
- If you become unable to work, return to work, or recuperate in the middle of a week, you may be paid a lag payment. The lag payment would be 1/5 of your benefit rate for each workday you normally work.
How long can I collect TDI? What if my disability is long-term?
duration of your claim is equal to 36% of your total base period
wages divided by your weekly benefit rate (not including dependent's
allowance. The most you are allowed to collect is an amount
equal to 30 full weeks. You may claim these weeks any time you are medically certified as functionally unable to perform your work duties during your benefit year and you are out of work for a minimum of seven (7) consecutive days.
should consider filing for Social Security disability if your
condition is expected to last at least a year. You don't have
to wait until your Temporary Disability payments end to apply
for Social Security disability. The application process can
take up to 6 months so filing an application early is important.
Social Security can start paying disability benefits after you
have been disabled for 5 full months. Please visit social security's
website at www.socialsecurity.gov
for more information or contact Social Security at 1-800-772-1213
or call your local social security office.
May I get paid by my employer or receive benefits from a private short term disability insurance policy and still collect TDI or TCI?
- If you continue to be paid a salary, sick or vacation pay, or receive benefits from an additional disability insurance policy, while you are totally unable to work due to illness or non-work related injury, caregiver or bonding, you are allowed to receive TDI. However, you must not be performing any services for the company. If you are recuperating and transitioning into your regular work schedule but working reduced hours and in “Partial Return to Work” claim status, all earnings such as salary, sick, short-term disability payments, vacation, bonus, commission etc. must be considered.
Can I collect TDI or TCI and Unemployment Insurance (UI) for the same
period of time?
- You cannot receive TDI or TCI and UI for the same period. If you become disabled or unable to work due to caring for a seriously ill family member or bonding with a child while collecting UI, you should file for TDI or TCI and immediately notify UI.
I'm pregnant. Can I collect TDI?
- If your Qualified Healthcare Provider (QHP) determines that you are unable to perform your customary and regular work duties due to medical complications as a result of your pregnancy and/or other health issues, it is recommended you file for TDI.
Note: TDI is not for maternity leave; TDI provides benefit payments only when you are certified by a QHP as functionally unable to perform your customary and regular work duties.
When I recuperate from delivering my baby, can I apply for a “Bonding” claim?
- Yes, you must file another claim if you are requesting benefits to bond with a newborn child
I filed for Workers' Compensation (WC). Can I collect TDI or TCI too?
- You cannot receive TDI or TCI for any period that you receive WC. If you were injured on the job you must file a claim for WC. If you have filed for WC and the claim is being contested, you may be eligible for TDI or TCI pending settlement of the WC claim. If you later receive WC for any weeks that TDI or TCI has been paid, you must notify us immediately so that any adjustments can be made.
I don't agree with a TDI or TCI decision regarding my claim. What can
have the RIGHT TO APPEAL any decision with which you do not
agree, by submitting a request in writing to the TDI Appeals
Coordinator at PO Box 20100, Cranston, RI 02920-0941 or by FAX
at (401) 462-8466. Your case will be assigned to a Referee (Hearing
Officer) at the Board
of Review who will schedule a hearing at which time you
may state your argument in detail.
You may bring witnesses or someone to represent you. You should
bring any documents or other evidence that will support your
claim. The Board is an impartial authority not under the direction
of the Department of Labor and Training.
I've recovered, but I have no job. What can I do?
- You should visit any of the
Department's One-Stop Career Centers - netWORKri
Centers. They can help you find work, enroll in training,
and provide job counseling. You should also file an Unemployment Insurance claim by
calling (401) 243-9100 or visiting www.dlt.ri.gov/ui.
Who pays for TDI/TCI?
- The TDI/TCI program is financed entirely by employee payroll deductions. The current withholding rate as of January 1, 2017 is 1.2% of your first $68,100 in earnings. Workers aged 14 and 15 are exempt from wage deductions and TDI/TCI coverage. If you worked for more than one RI employer in a calendar year and your total wages were more than $66,300 (in 2016), you may be entitled to a TDI tax refund. You can download a TDI tax refund claim form on-line at http://www.uitax.ri.gov/docs/TX-Forms/2016/TX17-2016.pdf. You can also obtain the refund form from the Division of Taxation, 1 Capitol Hill-Suite 36, Providence, RI 02908, (401) 574-8700.
Are TDI benefits taxable? Are TCI benefits taxable?
- TDI benefits paid to you are not subject to Federal or State income taxes. TDI withholdings from your earnings are deductible for Federal income tax reporting purposes.
TCI benefits paid to you are subject to Federal and State income taxes. You will receive a General Form (G-1099) at the end of the year indicating the amount you received in benefits, which will also be reported to the IRS.
Can I work part-time and receive TDI?
your QHP tells you that you are able to return to work part
time and your employer has work available for you, you may be
eligible to collect partial TDI payments. You are eligible to
collect a partial TDI payment for any week, beginning on or
after January 1, 2006, in which you have earnings of less than
your weekly benefit rate. You must be totally unable to work
for at least 7 consecutive days before you are eligible to receive
partial benefits. For more information, visit our Partial
Return to Work Program web page.
Can I work part-time and receive TCI? No, the Partial Return to Work Program (PRTW) (28-41-5d) is not for Bonding and Caregiving claims. The PRTW Program exists to facilitate the transition for an individual to return to their normal working hours while continuing their recuperation; therefore, not pertinent to the TCI Program.
Can my TDI/TCI benefits be directly deposited to my bank account?
have the option of having your benefits electronically deposited
into your savings or checking account or receiving payment via
the Electronic Payment Card (EPC). Click here to go to the EPC
FAQ's for TDI.
If you think direct deposit will benefit you, be sure to complete
the Request for Direct Deposit section of the TDI/TCI Application
for Benefits. You may call (401) 462-8420 to have a Request
for Direct Deposit mailed to you. If you want your benefits
deposited into your checking account, you must attach a check
marked "VOID" to your application. If you want your
benefits deposited into your savings account, you must attach
bank documentation that includes your account number and the
bank routing number.
How does TDI obtain my medical documentation to determine eligibility?
- A medical certification form (TDI-3 or TDI-3C) will be mailed to your home address when your application is entered into the TDI system. When you receive the form, it’s your responsibility to deliver the form to your treating Qualified Healthcare Provider (QHP). When the form is completed, either you or the QHP may mail or fax it to our office.
The medical certification form was returned to TDI, why hasn’t the claim been paid?
- Receipt of the completed form does not guarantee payment as it must be reviewed & approved. After review, if the duration exceeds the Official Disability Guidelines for the diagnosis, TDI may require additional documentation to support the certification. This additional documentation will be requested directly from the QHP & this will result in additional processing time for the claim.
What if my QHP requires my authorization to release medical
- If your QHP requires your authorization before releasing any medical information to TDI, it is your responsibility to sign any medical release forms that your QHP may require to be signed. Please be sure to ask your QHP if he/she requires your signature on any medical release forms since you are applying for TDI.
How is the Release of Medical Information handled for the Caregiver (TCI) claims?
- The claimant is responsible to obtain the medical documentation and any release of medical information for TCI claims.
What is the Claims Management Unit?
- The Claims Management Unit (CMU) established in TDI is staffed by Registered Nurses whose role is to review TDI claims when the medical duration extends beyond the medical duration guidelines. They also provide program information to claimants, employers and QHPs on how the TDI program operates.
Why am I not being paid TDI benefits for all the weeks the Qualified Healthcare Provider (QHP) approved as needed for my recovery period?
- When the illness begins in the middle of the week, the first benefit payment will reflect an adjusted payment which counts against the weeks provided by your QHP although you can not receive a full benefit payment.
- 40. If I am currently receiving TDI benefits and have a new doctor, how do I inform TDI?
- Due to a TDI claims processing change, it is no longer necessary for you to notify TDI when a new doctor begins treating you while you have an active TDI claim. When you receive your next medical certification form, clearly print the name & address of the new QHP (doctor) in as instructed on the form & take it to the new QHP for completion.
What are the Official Disability Guidelines (ODG)?
- This is a medical industry standard guideline (software program) used by TDI to determine the disability durations required according to each claimant’s disability. This program is used to calculate how long the average recuperation time is according to the specific illness/injury.
Can I attend school while receiving TDI benefits?
- Under most circumstances you cannot collect TDI if you are attending classes, engaged in clinical rotations, or student teaching etc. However, you may qualify if your work [in terms of specific disability] is materially different from your course of study. (For example, a manual laborer with a broken leg may be able to do classroom work but not his regular job.)