• Seton Hall University
• Policies and Procedures

Purpose

This Temporary Disability Benefits policy (the “Policy”) provides guidance to employees who are eligible for benefits from the University’s temporary disability insurance carrier (the “TDB Carrier”) and require a leave of absence because of a non-work related illness or injury, or pregnancy. The Policy provides benefits mandated by the New Jersey Temporary Disability Law, as well as certain additional University benefits set forth below. This Policy does not apply to Workers’ Compensation benefits or to New Jersey Family Leave Insurance benefits.

Scope

This policy applies to all University employees.

Policy

1. 1. Eligibility Requirements and Temporary Disability Insurance Benefit Prerequisites 
      
      The TDB Carrier reviews all disability claims and is solely responsible for approval, or denial, of a claim based on information provided by the employee’s attending physician or healthcare provider and other relevant information.
      
      To be eligible for temporary disability insurance benefits, the employee must follow the Procedures set forth below and:
      
      
      • (a) have had at least twenty (20) calendar weeks of covered New Jersey employment in which the employee passed the wage earnings threshold established for that period by the State of New Jersey, Department of Labor and Workforce Development; and
        
        
      • (b) have a disability due to a non-work related illness or injury, or pregnancy, that has continued for at least eight (8) consecutive days.
        
        
   2. Procedures
      
      
      • Initial absences that occur during the eight (8) day eligibility period must be reported by the employee to the employee’s supervisor, following departmental notification procedures.
        
        
      • After three (3) consecutive days of absence, the employee is required to have the employee’s healthcare provider fax or email a note documenting the employee’s continued absence from work and provide an expected date of return to work. This note is to be sent to the Department of Human Resources at 973-761-9007 or scanned and emailed to [email protected]. The employee should also be in contact with the Benefits team within Department of Human Resources to discuss leave options pertaining to their non-work related illness.
        
        
      • The Department of Human Resources will monitor the appropriate use of accrued sick leave or vacation hours (if sick leave hours have been exhausted) during the eight (8) day eligibility period and communicate with the employee, if necessary.
        
        
      • The employee is responsible for contacting the TDB Carrier to file a disability claim and for making sure the employee’s legally licensed healthcare provider (see N.J.S.A. § 43:21-39(d)) submits required and timely documentation to support the claim, including a certification from the healthcare provider as to the employee’s total inability to perform the employee’s duties of employment. The appropriate forms may be obtained by contacting the Benefits team within the Department of Human Resources.
        
        
      • Following the initial approval of a claim by the TDB Carrier, the employee’s healthcare provider must provide timely medical updates as requested by the TDB Carrier if temporary disability insurance benefits are to continue. To avoid the claim being terminated by the TDB Carrier, it is imperative that the employee make sure the employee’s healthcare provider submits required medical documentation to the TDB Carrier on time. Failure to do so may result in a delay/ reduction in the employee’s pay or termination of the employee’s temporary disability insurance benefits.
        
        
      • The employee may be required to submit to an independent medical examination (IME) by a doctor designated by the University or the TDB Carrier. The employee must cooperate with the IME, including providing all requested medical information.
        
        
      • Throughout the period of leave during which the employee is receiving temporary disability insurance benefits from the TDB Carrier’s, the employee is responsible for maintaining regular communication with the Department of Human Resources’ benefits team concerning the need to continue on a leave of absence and the anticipated date of return to work. The employee is responsible to immediately inform the Department of Human Resources’ benefits team if a return-to-work date is provided by the employee’s healthcare provider. The Department of Human Resources will then inform the employee’s supervisor of the employee’s return to work date.
        
        
      • Based on the medical information provided by the employee’s healthcare provider the TDB Carrier will determine the length of the temporary disability insurance coverage and when a claim will be terminated.
        
        
      • Faculty must review their applicable faculty guide for additional information and requirements.
        
        
   3. Pregnancy
      
      Eligibility for temporary disability insurance benefits and the claim filing procedure are the same for pregnant employees as they are for any other disabling condition. For a normal pregnancy, temporary disability insurance benefits are usually payable for up to four (4) weeks before the expected delivery date and up to six (6) weeks after the actual delivery date (provided that the employee has not worked during that time). A doctor may certify that the employee is disabled for a longer period if she:
      
      
      • experiences specific complications related to pregnancy;
      • undergoes a Cesarean section;
      • has another simultaneous disability; or
      • is physically unable to do her regular job.
      
      A claim for temporary disability insurance benefits because of pregnancy should not be filed before the employee’s doctor advises that the employee is disabled and unable to work.
      
      The claim should not be filed until the employee has actually stopped working.
      
      
   4. Duration of Temporary Disability Insurance Benefits/Long Term Disability
      
      Temporary insurance disability benefits under this Policy are payable from the eighth (8th) consecutive day of disability and for each day thereafter that the disability continues up to a maximum of twenty-six (26) weeks. The seven (7)-day waiting period becomes compensable when temporary disability insurance benefits have been paid for all or some part of the three (3) weeks following the waiting period.
      
      If it is anticipated that the disability will continue for more than twenty-six (26) weeks, the employee should contact the TDB Carrier to determine whether the employee may be eligible for insurance benefits under the University’s Long Term Disability Plan.
      
      
   5. Discontinuance/Denial of Temporary Disability Insurance Benefits
      
      An employee otherwise eligible for temporary disability insurance benefits based on a certification from the employee’s healthcare provider that the employee is unable to perform the employee’s duties of employment for a given period of time may, nevertheless, have the temporary disability insurance benefits reduced, terminated or denied because of one or more of the following circumstances:
      
      
      • The TDB Carrier and the healthcare provider have reached a mutual agreement as to a change in the employee’s period of disability.
      • As the result of an Independent Medical Examination (IME), it has been determined that the employee is no longer disabled, in which case temporary disability insurance benefits shall not be paid beyond the date of the IME.
      • The employee refuses to submit to or attend an IME, or otherwise fails to cooperate with the IME (such as failing to supply requested medical information), in which case the employee is disqualified from all temporary disability insurance benefits except those previously paid.
      • The University or the TDB Carrier has obtained credible factual evidence showing that the covered employee is performing activities that demonstrate that the employee is able to perform the regular duties of the employee’s employment, in which case temporary disability insurance benefits shall not be paid beyond the date that such factual evidence is obtained.
      • Temporary disability insurance benefits also may be denied if:
        1. the employee’s injury was intentionally self-inflicted;
        2. the employee was injured during the employee’s perpetration of a crime;
        3. the employee becomes disabled after having been suspended or discharged for misconduct; or
        4. the employee becomes disabled during a work stoppage due to a labor dispute.
           
           
   6. Return to Work
      

      
      Employees returning to work from leave must have authorization from their healthcare provider to do so. This authorization is to be sent to the Department of Human Resources, to the attention of the benefits staff, via fax at 973-761-9007 or scanned and emailed to [email protected] as soon as their return date is known, but not less than three (3) days prior to the return-to-work date. The employee must not return to work until the Department of Human Resources benefits staff have confirmed the date of the employee’s return to work.

      When a claim is terminated by the TDB Carrier, the employee is expected to return to work on the next regularly scheduled work day. If the employee cannot return to work on the next regularly scheduled workday, the employee must follow normal call out procedures and supply medical documentation by fax to the Department of Human Resources supporting the employee’s continued absence within two (2) days of the return-to-work date. Failure to return to work, follow normal call out procedures or to provide medical documentation within two (2) days following the return-to-work date will lead to termination of employment, unless the employee is prevented from doing so by reason of extreme emergency.

   7. Prohibition Against Working Elsewhere During Leave 

      
      Once a TDB claim has been approved, the employee is not permitted to perform any work for remuneration or profit while on a leave of absence during the period of disability. If the employee is found in violation of this restriction, the employee’s employment will be terminated, and the employee will not be entitled to temporary disability insurance benefits for any period during which such work was performed, and all future benefits will be cancelled.

   8. Appeals 
      
      If the employee disagrees with the TDB Carrier’s determination denying temporary disability insurance benefits, the employee has the right to appeal to the Division of Temporary Disability Insurance. The appeal must be filed within one (1) year of the date the disability began. The employee should send the written appeal to:
      
      Division of Temporary Disability Insurance
      Private Plan Operations
      Claims Review Unit
      PO Box 957
      Trenton, NJ 08625-0957
      
      
   9. Return to Work With Reasonable Accommodations or in a Modified Duty Temporary Position*
      
      An employee with a non-work related illness or injury may request to return to work in lieu of receiving the temporary disability insurance benefits otherwise then available under this Policy under the following circumstances:
      
      
      1. The employee can perform the essential functions of the employee’s job with reasonable accommodations. The employee must adhere to the requirements of the University’s Policy on Reasonable Accommodations for Employees with Disabilities.
         
         
      2. An employee (a) who cannot perform the essential functions of the employee’s job with or without reasonable accommodations and (b) whose disabilities are temporary, may request a modified duty temporary position in accordance with the University’s Policy on Reasonable Accommodations for Employees with Disabilities. The University will determine the duration of any temporary position offered on a case-by-case basis. The University may require that a request for a modified duty temporary position be supported by a certification from the employee’s healthcare provider that the employee is able to perform all of the duties of the temporary position. The University retains complete discretion over whether to offer the employee a modified duty temporary position and when to terminate the position.
         
         
      In accordance with Faculty Guide, Article 6.3(b)(3), faculty members must work with their deans and chairs upon the return to work and assigned alternate duties if teaching duties are not resumed.
      
      *Bargaining unit employees should consult their applicable collective bargaining agreement as it relates to this provision.
      
      
   10. Enforcement of Return to Work 
       
       An employee who is released to return to work, either with or without restrictions, by the employee’s healthcare provider must contact the benefits team within the Department of Human Resources as soon as the information is known by the employee or no later than three (3) days prior to the anticipated date of the return to work, whichever is earlier. The Department of Human Resources will inform the employee’s supervisor of the employee’s anticipated return to work date. If the employee does not return to work on the date anticipated by the University, the employee must follow normal call out procedures and supply medical documentation supporting the employee’s need for a continued absence by fax or by scanning and emailing same to the Department of Human Resources within two (2) days of the return-to-work date. Failure to return to work as anticipated, follow normal call out procedures or to provide medical documentation within two (2) days following the inability of the employee to return to work on the anticipated date will lead to termination of employment, unless the employee is prevented from doing so by reason of extreme emergency.
       
       
   11. Employee Compensation
       
       The employee will receive the temporary disability insurance benefit check directly from the TDB Carrier. For a period of disability covered by the TDB Carrier, the amount payable is 85% of regular weekly wages up to a maximum as declared annually by the State of New Jersey, Department of Labor and Workforce Development. Please view the State of New Jersey’s website for the most up-to-date information at https://www.nj.gov/labor/myleavebenefits/worker/tdi/.
       
       
       1. Faculty and Administrative Employees
          In accordance with NJ Temporary Disability Law, the University may pay all or part of the difference between the employee’s regular weekly wage and the weekly temporary disability insurance benefit amount with no impact on the claim. The total income received cannot exceed the regular weekly wages.
          
          For qualified faculty members and administrators, the University may provide a Salary Continuation benefit that pays up to 100% of the difference between the temporary disability insurance benefit amount and the employee’s base monthly pay, provided the employee has a sick leave balance of at least 70 hours and authorizes the use of those hours during the first 10 days of the disability period. Failure of the employee to authorize the University to use the 70 sick hours prevents the University salary continuation payments for qualified faculty and administrators.
          
          The following chart outlines Seton Hall University’s Salary Continuation Program for qualified faculty members and administrators:
          
          Approved Disability Amounts
          
          

          Length of Approved Disability	Less than One Year of Employment	One Year of Employment and Hired On or After 10/15/1984	Hired Prior to 10/15/1984
          First Month	100%	100%	100%
          Second Month	60%	100%	100%
          Third Month	60%	60%	100%
          Fourth Month	0%	60%	100%
          Fifth Month	0%	60%	100%
          Sixth Month	0%	60%	100%

          The employee will receive Salary Continuation only for the duration of the temporary disability period as approved by the TDB Carrier.
          
          If the employee does not qualify for Salary Continuation benefits, the employee will only receive temporary disability insurance benefits paid by the TDB Carrier.
          
          
       2.  Staff Employees
          
          
          • If the TDB Carrier does not cover the first seven (7) days of the period of absence due to the temporary disability, the employee may use sick hours, or vacation hours if sick time is exhausted, for a full working day (7 or 8 hours).
          • During remaining periods of leave due to the temporary disability, the employee may use sick hours and vacation hours to supplement the temporary disability insurance benefit payments. The use of sick hours and vacation hours will be limited to approximately 1/3 of weekly pay. The combined income from sick hours, vacation hours and disability payments cannot exceed regular weekly earnings.
          • An employee without accrued sick or vacation hours at the start of a leave due to a period of temporary disability will receive the temporary disability insurance benefit payment issued by the TDB Carrier only.
            
            
   12. Employment Status and Other Benefits
       
       
       • • Bargaining unit employees should review their applicable collective bargaining agreements for information regarding employment status during an approved disability leave.
           
           
         • The New Jersey Temporary Disability Law provides eligible employees up to 26 weeks of job protection while employees are collecting temporary disability insurance benefits, entitling the employee to be restored to the position held by the employee when the period of leave commenced or to an equivalent position of like seniority, status, employment benefits, pay, and other terms and conditions of employment.
           
           
         • Medical benefits for employees receiving temporary disability insurance benefits will continue up to a maximum of 26 weeks. Any required employee contribution for medical health coverage or other University benefits will automatically continue during Salary Continuation. Employees not eligible for Salary Continuation will be required to make payment of the employee contribution for medical health coverage and other University benefits to the University no later than the 15th of each coverage month. Contact the Benefits team of the Department of Human Resources at [email protected] to make necessary arrangements for payment to prevent any lapse and/or termination of coverage.
           
           
         • Vacation and sick time does not accrue when an employee is not actively at work.
           
           
         • Retaliation against employees who requested or received temporary disability benefits is prohibited.

IMPORTANT DISCLAIMER: This Policy does not create a contract of employment or alter the at-will employment relationship between the University and its employees. Nothing contained in this Policy shall limit the right of either the University or the employee to terminate the employment relationship at any time, with or without cause.

An employee’s work-related illness or injury is not covered by this Policy, but is covered under the provisions of the New Jersey Workers’ Compensation Law.

Related Policies

Family Medical Leaves
Employee Handbook
Faculty Guide

Responsible Offices

Department of Human Resources

Approval

Approved by A. Gabriel Esteban, President, on the recommendation of the Executive Cabinet on April 22, 2016. Amended and approved by Monsignor Joseph R. Reilly, S.T.L., Ph.D., President, on the recommendation of the Executive Cabinet, on August 26, 2026.

Effective Date

April 22, 2016. First Amended: August 26, 2026.