Notice Of Data Event

Submit a New
TDI Claim

State of Hawaii law requires employers to provide wage replacement insurance when applicable. Temporary Disability Insurance (TDI) supports you during challenging times by offering partial wage replacement if you’re unable to work due to a non-work-related illness or injury. Submitting a TDI claim is the first step toward ensuring you receive this essential financial support, allowing you to focus on your health and recovery.

At Pacific Guardian Life, we’re committed to helping you navigate the process smoothly so you can access the benefits you deserve. Our dedicated team focuses on delivering outstanding customer service at every stage of the process and offers an easy-to-use online form for submitting TDI Claims.


File a TDI Claim Online

Whether you are a claimant, employer, or physician, we welcome you to conveniently complete your section of the TDI-45 Form by using the links below.

I am a Claimant

To submit a new TDI claim, select Part A and follow the instructions.

I am an Employer

To submit Part B for a TDI claim on behalf of your employee, select Part B and follow the instructions.  

I am a Physician

To submit Part C for a TDI claim on behalf of your patient, select Part C and follow the instructions. 

Print and send TDI Form using alternate method

Contact Us

Should you have any questions on completing or submitting the form, please email [email protected] or call (808) 942-1282.