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Temporary Disability Insurance Module

Temporary disability insurance (TDI) programs are among the lesser known insurance programs administered by state workforce agencies. These programs provide benefits to workers who are temporarily unable to work for reasons that are not job-related, such as sickness, injury or the need to care for sick family members. Though TDI qualifications differ from those of UI benefits programs and Workers' Compensation, all three share the purpose of supporting temporarily unemployed workers. The jurisdictions that currently provide TDI programs are: California (1946), Hawaii (1969), New Jersey (1948), New York (1949), Puerto Rico (1968), and Rhode Island (1942).

TDI benefits are typically paid for a limited duration, like the 26-week period for UI benefits, and should not be confused with the temporary disability provisions provided under the Federal Social Security Program, which require that the disability be of longer duration in order to qualify.

Customized audits developed with input from states that provide temporary disability insurance

In discussing the Aware suite of products with one of these jurisdictions, On Point Technology staff were asked to collaborate with the Agency to compile a set of audits to seek out fraudulent TDI claims. As a result, On Point Technology developed the Temporary Disability Insurance module.

As with the other insurance programs, the rules and regulations for temporary disability insurance vary from state to state. TDI laws will very greatly regarding the funding of program benefits and administration, the extent of coverage for disabilities that onset during employment, the requirements of using state fund coverage versus private insurance plans, and the disabilities that are excluded from coverage. Among the more specific and detailed distinctions from state to state are matters like who is covered, earnings requirements, definition of disability, weekly benefit rate, qualifying wages, dependency allowances, employee contributions, total amount of benefits and duration, pregnancy coverage, waiting period, and base period and alternatives.

However, there are a few static guidelines among TDI programs:

• TDI benefits and UI benefits cannot be paid for the same week.
• TDI benefits and Workers' Compensation benefits cannot be paid for the same week.
• A certified health care provider must attest to the claimed disability.
• Coverage is mandatory for certain workers.

Unfortunately, as is the case with other insurance programs, there are always attempts to defraud the system, which is why On Point Technology has released the Aware-Temporary Disability Insurance module. In consultation with several states that provide temporary disability insurance, On Point Technology developed a set of "one-click" audits focus on identifying possibly fraudulent TDI claims. With these audits, you can seek at such fraud indicators as claimants filing continued claims for the same disability or filing multiple claims at the same time of year. And with the advanced functionality of the Workforce Reporter tool you can perform these audits immediately and at your convenience, without the need for programming skills or any understanding of the underlying data structure.

View the list of 21 "one-click" audits for the Aware-TDI module.