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Business Insurance
> Temporary Disability >
Filing A Claim
If you suffer a disabling nonwork-connected injury or sickness
and your employer provides insured statutory benefits:
- Notify your employer immediately of your disability.
- Ask for Form TDI-45, Claim for TDI benefits.
- Complete Part A, Claimant's Statement, of the claim form.
- Have your employer complete Part B, Employer's Statement.
- Take the form to your doctor to complete Part C, Doctor's Statement.
- Mail the form to your employer or to your employer's TDI insurance company.
- Your employer or the insurance company will notify you of your entitlement to benefits.
The law requires that you file your claim
within 90 days from the date you were disabled. If you file your
claim after 90 days, you may lose part of your benefits unless good
cause can be shown. If you file your claim 26 or more weeks after
your disability, you will not be entitled to any benefits. To avoid
partial or complete loss of benefits, file your claim within 90
days.
Your employer or insurance carrier is required to send you written
notice if your claim is denied. If you disagree with the denial,
you may appeal by explaining why you disagree on the notice and
send two copies to the TDI office. You have 20 days in which to
appeal.
The TDI office will notify you of the time
and place of the appeal hearing. An impartial referee will hear
your case. Although it is not required, you may have an attorney
represent you at the hearing. If you do not agree with the referee's
decision, you may further appeal to the circuit court.
You may appeal to the TDI office if you disagree with the amount of benefits paid you by your employer or the TDI insurance carrier. Bring evidence such as pay slips or check stubs to prove you are entitled to more benefits.
Inquiries
If you have the following inquires regarding Temporary Disability
Insurance (TDI), please address them to the location nearest you:
- If you need more information regarding TDI
- If your employer does not provide TDI benefits
- If you disagree with a claim and need to appeal the claim
Oahu |
P.O. Box 3769 830 Punchbowl Street,
Rm. 210
Honolulu, Hawaii 96812
Phone: (808) 586-9188 |
Hawaii |
State Office Building
75 Aupuni Street
Hilo, Hawaii 96720
Phone: (808) 933-4391 |
West Hawaii |
Ashikawa Building
P.O. Box 49
Kealakekua, HI 96750
Phone: (808) 322-2775 |
Maui |
State Office Building, #2
2264 Aupuni Street
Wailuku, HI 96793
Phone: (808) 243-5322 |
Kauai |
State Office Building
3060 Eiwa Street
Lihue, Hawaii 96766
Phone: (808) 241-3351 |
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