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PACIFIC GUARDIAN LIFE INSURANCE CO., LTD. 1440 KAPIOLANI BOULEVARD, SUITE1700 HONOLULU, HAWAII 96814 PHONE: 9421282 FAX: 9421284 RESET FORM CLAIM FOR DISABILITY BENEFITS INSTRUCTIONS FOR FILING A.

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About Temporary Disability Insurance. ... The Hawaii Temporary Disability Insurance (TDI) law was enacted in 1969, which requires employers to provide partial wage replacement insurance coverage to their eligible employees for nonwork-related injury or sickness, including pregnancy.

To be eligible for TDI benefits, an employee must have at least 14 weeks of Hawaii employment during each of which the employee was paid for 20 hours or more and earned not less than $400 in the 52 weeks preceding the first day of disability. The 14 weeks need not be consecutive nor with only one employer.

The State of Hawaii does not assess a disability tax (SDI) and does not collect a disability tax payment since employers are required to obtain coverage. If the employer chooses to take a deduction from employees' paychecks, the employer uses that amount to pay for part of the cost of the TDI coverage.

You worked at least 14 weeks during each of which they have received renumeration in any form for 20 or more hours and earned wages of at least $400, during the 52 weeks immediately preceding the first day of disability. The 14 weeks need not have been consecutive nor with only one employer.

Notify your employer immediately of your disability. Ask for Form TDI-45, Claim for TDI Benefits, from your employer. ... Complete Part A, Claimant's Statement, of the claim form. Take the form to your physician to certify your disability on Part C, Doctor's Statement.

TDI is a "wage replacement" program that pays your employees benefits to partially replace loss of wages due to off-the-job injury or sickness. Employees on disability receive up to 58% of their average weekly wage up to the State of Hawaii maximum benefit amount.

Hawaii requires employers to insure employees or pay temporary disability benefits for up to six months. The State of Hawaii requires employers to provide temporary disability insurance (TDI) or payments to workers who suffer short-term, non-work related illness or injuries, including pregnancy.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232