Hawaii Disability Compensation Law Poster Mandatory

Workers' Compensation - You have the right to 	receive workers' compensation benefits and medical care if you suffer a work-
related injury. You must report the date, time and circumstance of your injury immediately to your employer or supervisor. Give the 
name of the insurer to your doctor so that your doctor will know where to send the physician's report. If your employer does not file a 
report of the injury, you may file a written claim with the Disability Compensation Division. You do not pay for the premium cost; your 
employer pays the entire amount.	
 	 You are entitled to all required medical, surgical and hospital services and supplies including medication; weekly benefits from the 
fourth day of disability to replace wage loss, representing 66 2/3% of your average weekly wage but not more than the maximum 
weekly benefit amount annually set by the Department; additional benefits if the injury results in permanent disability or disfigurement; 
vocational rehabilitation, if appropriate; funeral and burial expenses if the work injury results in death; and additional weekly benefits to 
the surviving spouse and other dependents.	
 
 	
Temporary Disability Insurance - You have the right to 	file a claim for temporary disability insurance benefits within 90 days 
from the date of disability if you suffer a disabling non-work-related injury/illness or inability to work because of your pregnancy. 
Your employer or insurance carrier should furnish you with a TDI-45 claim form or some other authorized claim form. You may receive 
TDI benefits if a physician properly certifies your inability to work. Generally, you must have worked for an employer in Hawaii at least 
two weeks before your disability. During the last 52 weeks, you must have: worked for at least 14 weeks; been paid for at least 20 
hours per week; and earned at least $400.	
 	 After a 7 consecutive day waiting period, you will be paid 58% of your average weekly wage, not to exceed the maximum in the TDI 
law. Your employer may have an "equivalent" plan approved by the Department, which may provide different benefits. You should ask 
your employer for details if they have an "equivalent" plan.	
 	 You may be required by your employer to share in the premium cost. Your share cannot be more than one-half of the cost and should 
not exceed .5% of your weekly wages. Your employer pays the remaining portion exceeding the prescribed limitation. If you are not 
eligible for benefits (see second paragraph above), your employer cannot deduct any contributions from you to share in the premium 
cost.	
 
 	
Prepaid Health Care - You have the right to 	enroll in your employer's prepaid health care insurance plan after 4 consecutive weeks of 
employment where you have worked at least 20 hours each week. The Department of Labor & Industrial Relations must approve 
the health care plan and include insurance coverage for hospital, surgical, medical, diagnostic and maternity medical care. 	
 You should claim benefits under this program if a non-work-related injury or illness requires medical care. Give your doctor or hospital 
the name of your employer's health care contractor and the plan name.	 	
 If you are required to share in the premium cost for your coverage, your share cannot be more than 1.5% of your monthly wages or 
one-half the premium cost (whichever is less). Your employer pays the balance.	 	
 Disability Compensation Division:	 	Oahu 	586-9161 (Workers'  Compensation) 586-9188 (Temporary Disability Insurance and Prepaid Health Care) 
Hilo  974-6464	 	Kona  322-4808	 	
Maui	. 	243-5322	 	Kauai  274-3351	 	  This notice provides general background information on labor laws administered and enforced by DLIR's Disability 
Compensation Division and is not intended to serve as a substitute for legal counsel. For specific legal advice on 
individual situations, please consult an attorney.	
 	 Anne E. Eustaquio, Director	 	Department of Labor and Industrial Relations	 
 	
*You may satisfy Hawaii Labor Laws’ posting requirements by posting our official labor law poster. For more information: http://labor.hawaii.gov/labor-law-poster/  
 
 
 	
Equal Opportunity Employer/Program 
Auxiliary aids and services are available upon request to individuals with disabilities. 
TDD/TTY Dial 711 then ask for (808) 586-8866. 	
 
 	
Revised 09/21/2020