• Provides income support to individuals out of work due to a non-work related illness or injury

• Certification by a Qualified Healthcare Provider (QHP) that individual is unable to work for at least 7 consecutive days.

QUALIFIED HEALTHCARE PROVIDERS DEFINED

• Midwives, Nurse Practitioners, Physician Assistants, Physicians, Psychiatric Clinical Nurse Specialists (PCNS).

QHP RESPONSIBILITIES

• Provide patient medical reports when requested by TDI

CLAIMS MANAGEMENT SYSTEM

• Designed to monitor claims that exceed MDG.
  
  
• Registered Nurses contact QHPs and customers when duration exceeds MDG.

FRAUD AND MISREPRESENTATION PREVENTION

• Law allows for the impartial medical examination of TDI beneficiaries.
  
  
• Claims referred to Medical Consultant for review and recommendation as needed.
  
  
• Fraud Unit investigations and prosecutions if warranted.
  
  
• Communication with WC Court and insurers to prevent overlap of benefits.
  
  
• MEDICAL DURATION GUIDELINES (MDG)
  
  
• MDG used by Medical Review Unit to determine disability durations.

TDI AND WORKERS' COMPENSATION (WC)

• TDI and WC cannot be received for the same weeks.
  
  
• WC claim must be filed if the illness/injury occurred on the job.
  
  
• If WC claim is contested a TDI claim can be filed.
  
  
• TDI reimbursed if WC then paid for weeks TDI has been paid.