TDI Hawaii: How to Get Temporary Disability Insurance in Hawai’i

Hawai’i is one of the few American states that has a mandatory Short-Term Disability program. The details are quite different from the programs of other states, but SDI programs can be life-saving when you have a major medical event, pregnancy, or illness that requires you to take time off from work.

If you are an employee and resident of Hawai’i, here are the major takeaways to keep in mind if you need to make a claim.

Hawaii Temporary Disability Insurance: Key Takeaways

• Hawai’i is one of only five states to have mandatory SDI
• State law requires employers to provide Temporary Disability Insurance for their employees but does not fund the program itself. Employers are responsible for providing TDI coverage, which can be done through fully insuring, self-insuring, or following a collective bargaining agreement.
• Employees eligible for TDI benefits must meet the statutory minimum requirements, including criteria regarding employment duration, hours worked, and earnings. Employers can offer higher benefits if they choose.
• If your employer says that they do not have a TDI policy, you can contact the nearest Investigation Section of the Department of Labor and Industrial Relations District Office

What is Temporary Disability Insurance (TDI)?

Temporary Disability Insurance, also known as Short-Term Disability Insurance, is a program that replaces a portion of an employee’s wages when they are unable to work for a while due to illness or injury. Generally, TDI covers injuries that are unrelated to work, like surgery, cancer treatment, or childbirth.

Work-related injuries generally fall under Worker’s Compensation, not TDI. In some states, you can take time off with TDI to care for a sick family member or a new child, but Hawai’i also has its own family leave law for that purpose. We’ll go over the details in this article.

Who Qualifies for Hawai’i SDI?

Most employees who are residents of Hawai’i are eligible for SDI and can apply for benefits at any time, but there are some exceptions. For example, federal employees living in Hawai’i, certain family employees, and certain domestic workers are not eligible for state benefits.

You also need to be under the care of a licensed practitioner who can certify your disability. This can be a physician, a surgeon, an osteopath, a dentist, a physician’s assistant, or another accredited practitioner.

You also need to be currently employed to qualify for short-term disability benefits in Hawai’i. What counts as currently employed? To be considered ‘currently employed,’ you need to have been employed immediately before becoming disabled or suffering injury and illness, or your disability must have set in within two weeks of your last work day.

If you worked two jobs simultaneously, you may qualify for TDI benefits from both employers as long as you meet the eligibility requirements. This applies whether the jobs are part-time or full-time.

Which Workers in Hawai’i are Not Eligible for Short-Term Disability Insurance?

Not all workers in Hawai’i, even full-time employees, are eligible for short-term disability. This includes federal government employees as mentioned before, people paid solely on commissions (like real estate agents, insurance agents, and some salespeople), people under 18 years old, interns, student nurses, and certain domestic workers.

There are also disqualifying conditions. For example, you may be ineligible for benefits if:

• You intentionally caused your injury, or you were injured while committing a crime
• You worked for pay at any time during your period of disability
• You have already received or will receive workers’ compensation, federal disability benefits, or unemployment insurance
• You filed your claim more than 90 days after the start of your disability without a valid reason
• You made false claims in your application or failed to disclose relevant information

The situation is also a little bit different for Hawai’i state or county employees. Generally, the government sick leave covers the TDI benefits for these employees, but you may be entitled to more SDI benefits if you had less than three weeks of sick leave credits (used and used) before the disability set in. You can contact your employer’s personnel office to file a claim.

How Much Money Do I Need to Earn to Qualify for Temporary Disability Insurance in Hawai’i?

In order to be eligible for Temporary Disability Insurance (TDI) in Hawai’i, you must have worked at least 20 hours a week for at least 14 weeks of employment in Hawai’i and earned at least $400 in the 52 weeks before the first day of your disability. The 14 weeks can be with different employers and do not have to be consecutive.

How is Hawai’i Temporary Disability Insurance Funded?

Hawai’i is unusual in that the state Temporary Disability Insurance is not funded by the government. The state government instead requires employers to provide TDI, and the state determines the minimum benefits that employers can offer.

Individual employers and companies can choose to pay the entire cost of the TDI premiums or share the cost with their eligible employees. The employer is allowed to deduct up to half of the premium for TDI from the employee’s pay, but it cannot be more than 0.5% of their employee’s weekly pay. The Disability Compensation Division of Hawai’i has also placed a weekly maximum of $5.51 per week as of 2021.

The math is a little bit complicated, so let’s go over an example. Let’s say that we have an employee who earns an average of $500 per week. The premium for TDI is 80 cents per $100 of covered wages. For this employee, that would be $4.00 per week. The employer cannot make the employee pay for more than half of the premium, so the employee’s portion would be $2.00 per week. Next, we have to check if the amount is within the statutory limit. For this employee, 0.5% of their weekly salary is $2.50. This is below the $5.51 per week statutory limit, so this employee can contribute up to $2.50 per week.

How Are Your HI Temporary Disability Benefits Calculated?

Hawai’i is one of the few states that offers Short-Term Disability Insurance, but individual plans can vary from one employer to another. However, the state of Hawai’i mandates a minimum plan called the statutory plan.

If your employer offers the statutory plan, this is what you can expect:

• You are entitled to receive 58% of your average weekly wages
  • The maximum weekly benefit as of 2021 is $640, so even if 58% of your income is higher than this amount, you will receive no more than $640
• Benefits begin on the eighth consecutive day of disability, so you will not receive benefits for the first seven days that you are disabled
• A maximum of 26 weeks of benefits can be collected. If your disability persists beyond that point, you may need to apply for SSDI or SSI.

However, your employer may have a different plan than the minimum statutory set by the state government.

How to Apply for Hawai’i State Disability Insurance

You can apply for Hawai’i State Disability Insurance by filling out a form and sending it to your employer’s TDI insurance carrier. If your employer does not have a TDI policy and you believe you are eligible, you can contact the Investigation Section of the Disability Compensation Division to help you.

How to Apply

If you have become disabled due to a non-work-related injury that will leave you unable to work for more than seven days, the first thing you need to do is tell your employer. You need to ask your employer for a Claim for TDI Benefits, or Form-45. If your employer is unable to provide you with this form for some reason, you can contact the Disability Compensation Division of Hawai’i directly.

You must file your TDI claim within 90 days of you becoming disabled and unable to work. You will fill out Part A of the form yourself because it is your information and statement. Your Employer will complete Part B, the Employer’s Statement. You will then need your doctor or physician complete Part C, the Doctor’s Statement, to verify your disability.

Either your employer or your employer’s insurance carrier will tell you what benefits you are entitled to. If your employer has an insurance carrier, you will mail your Form-45 to the insurance carrier instead of turning it into your employer.

State law requires you to make your claim within 90 days, and you could lose some of your benefits if you wait until after that. There are exceptions if you can prove a good reason for the delay, but the best thing is to be prompt in sending in the form. If you wait for more than 26 weeks before sending your claim after being disabled, you will no longer be entitled to benefits at all.

Hawai’i TDI Forms & Documents You Need

So what kind of documents and information do you need to be able to fill out these forms? For Part A, the Claimant section, you will need:

• Your personal information, such as name, birthday, social security number, etc
• Your disability information (like what caused it and when it started)
• The names of your current employer and all employers you have worked for in the last 52 weeks

You will not be filling out Parts B or C, the Employer’s Statement, or the Physician’s Statement, but you will want to make sure that your employer and physician fill out the sections in full. Your employer must fill out Part B in a timely manner. While the law does not specify a timeframe, if the employ er does not fill out Part B within a week or so, you can contact the Investigation Section of the Disability Compensation Division.

How to File an Appeal if Your Claim is Rejected

A claim may be rejected for reasons that have nothing to do with your eligibility. For example, if you filled out the information incorrectly, missed a section, or for other bureaucratic reasons. If your claim is denied, you will receive a Denial of Claim for Disability Benefits (Form TDI-46).

If you receive this denial and disagree with it, you have 20 calendar days to appeal. You will have to explain why you disagree with the denial and send two copies to either the Division or to the nearest Department of Labor and Industrial Relations field office.

If your claim is accepted but you disagree with the amount of benefits you are entitled to, you can also send a written appeal to the Honolulu office or the nearest Department of Labor and Industrial office. You will need pay stubs or other documents that prove the amount of money you were receiving before your injury or illness, and then the Division will give you a time and place for an appeal hearing.

Alternatives to State-Sponsored Disability Benefits in Hawai’i

What options do you have if you don’t qualify for Hawai’i Short-Term Disability or if the benefits aren’t enough? You have a few other options if you are injured and need to take off work for a while. Employers can also satisfy the sick leave benefit requirements through a collective bargaining agreement, provided the benefits are at least as favorable as those mandated by Hawaii’s Temporary Disability Insurance (TDI) law.

FMLA Leave

One option is the Family and Medical Leave Act (FMLA). FMLA is a federal program, not a state-run program, that protects your job for up to twelve weeks. Unfortunately, FMLA is not a wage replacement program, but it does allow you to maintain your health insurance benefits like when you were working.

This is especially helpful when you are injured or recovering from surgery and need to go to many doctor’s appointments in a short period. Even if FMLA doesn’t replace your lost wages, it can save you thousands of dollars by ensuring that you keep your health benefits.

To qualify for FMLA, the employer must have at least fifty employees, and the employee in question needs to have worked for that company for at least twelve months.

HFLL – Hawaii Family Leave Law

The Hawai’i Family Leave Law is a state law that applies to companies with one hundred or more employees. However, the definition of ‘employee’ is much looser than the federal standard. Unlike FMLA, the employee only needs to have worked for the employer for six months, and it applies to part-time workers, temporary workers, casual workers, and contract workers.

With HFLL, an employee may qualify for up to 4 weeks of unpaid family leave each year to care for a new child (including adopted children), spouse, parent, or other qualifying family member with a serious health condition.

Private Plan State Disability Insurance

If you are ineligible for Hawai’i TDI or want to explore other options, many private insurance companies offer short-term disability insurance. Whereas as an employee, you will have already paid for your mandatory state TDI with your paycheck (if your employer is not covering the expenses), you would be entirely responsible for the premiums of a private plan.

That said, you can also look for a more comprehensive plan, should you need it. Most of the time, you cannot get a short-term disability plan if you have already become temporarily disabled, so you will need to have the foresight to enroll in a plan before you are injured or sick. If you need short-term disability insurance for pregnancy and childbirth, make sure you get an SDI plan before you conceive.

Short-Term Disability Lawyers in Hawai’i

If you need short-term disability in Hawai’i and you’re not sure where to start, a good disability lawyer can help. Applying for Hawai’i TDI can be frustrating, especially if your employer isn’t cooperating or you need to appeal a decision. It is even harder when you are simultaneously recovering from an injury or caring for a new child.

A good disability lawyer will do all of the legwork to ensure that your documentation is complete and accurate so that you and your family get all of the benefits that you’re entitled to.