We wanted to make sure you have all the tools necessary to complete your New Jersey Disability Claim form smoothly. Take a look at the sample DS-1 form provided—it's your handy guide to completing your NJ Disability Claim with ease.
We're unable to provide direct assistance with filling out these forms. However, this guide will serve as a helpful resource to steer you in the right direction.
Feel free to use this legend as a guide while navigating through each page of your claim form.
NJ Disability Claim form page 1
NJ Disability Claim form page 1
NJ Disability Claim form page 2
NJ Disability Claim form page 2
NJ Disability Claim form page 3
NJ Disability Claim form page 3
NJ Disability Claim form instructions
NJ Disability Claim form instructions
Tips when filling out your claim form
Tips when filling out your claim form
The first day you are unable to work marks the beginning of your disability.
It's best to action your claim forms on or shortly after your disability begins.
Some carriers may accept claims earlier, but they won't start processing your claim until you are officially on leave.
It's quite common for insurance carriers to reach out either to you or your medical provider to request additional information to help streamline the approval process for your claim.
Claim forms often ask about wages while on leave. Your employer's policy might have some differences or nuances regarding wage continuation.
It's a good idea to reach out to your carrier for further information, as they are the ultimate adjudicators of your claim.
Answer the questions as best you can, and if you have any questions, don't hesitate to reach out to your carrier for help.
Here’s a helpful article to further explain pay while on leave.
Is there a deadline to submit claims?
Is there a deadline to submit claims?
Claims must be submitted to your state carrier no later than 30 days after you become sick or disabled.
If you're submitting your claim after the 30-day window, we recommend including a note explaining the reason for the delay to help stay proactive.
My claim is complete: what are the next steps?
My claim is complete: what are the next steps?
Upload completed forms to your dashboard here, and our team we’ll submit your claim form to the carrier.
Our team will usually submit your claim to the carrier within 24 hours of receipt and you'll receive an email to confirm. Here are some useful tips to help you take proactive steps and ensure speedy approval.
After receiving our confirmation that your claim has been submitted, promptly follow up with your insurance carrier (preferably within 2 business days) to ensure they have all the necessary information for a swift approval.
We don't collect bank information so your benefit payments will be in the form of checks, if you're interested in setting up direct deposit, this call to them would be an ideal opportunity to learn if that might be possible.
How can I check the status of my claim?
How can I check the status of my claim?
You'll want to reach out to the carrier directly to check on your claim's status.
You can find contact information for your carrier here.
Please understand that for privacy reasons, both state and private insurance carriers prefer to communicate directly with you after your claim has been submitted. Unfortunately, we won't have visibility into your claim once it's been submitted.
My leave has begun, and claim forms have been submitted, but I need to add/adjust the dates. What should I do next?
My leave has begun, and claim forms have been submitted, but I need to add/adjust the dates. What should I do next?
First, please make sure you adjust your leave dates within your Cocoon dashboard, and your People team will receive a notification.
If your leave has already begun and the carrier has your claim forms, it's a good idea to reach out to them directly to inform them of your new leave dates. They'll provide guidance on the next steps.
Please note that when changing your leave dates, Cocoon will provide instructions, including downloading new leave forms. However, it's a good practice to contact the carrier directly if your claim has already started. If your leave hasn't started yet, you can use the updated forms.
Questions? Reach out to the Cocoon Support team at [email protected]