When a New Jersey Temporary Disability Insurance claimant is already approved but needs more time off, the treating provider certifies the longer disability period through the online M-03 medical extension. There is no paper version. The claimant gives the provider printed instructions with a Form ID, and the Division receives the extension electronically with immediate confirmation.
The treating healthcare provider completes the whole online form; the claimant's part is supplying the printed instructions and Form ID.
Download the current version from the source each time; forms change without notice.
TDI Medical Extension (online medical certification to extend a TDI claim)
This form is completed online with New Jersey Department of Labor and Workforce Development, Division of Temporary Disability and Family Leave Insurance, so there is no PDF to fill. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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The claimant's unique Form ID, which appears on the printed instructions the claimant gives the provider. Without it the online system cannot match the extension to the approved claim. The provider then certifies the extended disability period and receives immediate confirmation.
No. The Division publishes M-03 as an online form only. Initial paper claims use Part C of the DS-1, and continued claims may come through the P-30 request the Division sends after approval, which the claimant and provider can also complete online.
No. The Division lists the M-03 extension only for approved Temporary Disability Insurance claims. For FLI caregiving claims, the online option is the initial FLI medical statement (M-01), which the care recipient's provider completes with the claimant's Form ID.