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ID Form 8484: What You Should Know

Forms CPT 2106, Disability Insurance, and/or CPT 2202, Disability Insurance Application for Employee. Forms CPT 2890, and CPT 2972 for disability for certain employees, or Form CPT 3910-E-4, Employer's Annual Disability Tax Return, to pay income tax on disability benefits. Form CPT 3910-E-4 may be used to determine whether an employee may elect to pay income taxes on disability benefits. It may also be used to file a claim for refund of the income tax due on certain disability benefits. Hawaii Department of Finance (DFF) has an Internet site where any citizen may download a copy of the Income Tax Code for Hawaii. If the citizen wishes to be provided with an exemption certificate for tax, the DFF must forward this notice by certified mail to the U.S. Postal Service (see 5.14F.1) or the Department of Business and Economic Development, Division of Consumer Services at-8100, Attention: Individual. An employee who is on probation or probationary status may be excused from paying income tax on disability. The employee must provide the Department with an authorization authorizing the exemption or be excused. Hawaii Department of Health provides a free, online application to apply for disability. The application has been developed by the Department of Health, and is available from the Statewide Information Technology website. Hawaii Tax Forms for Individuals with Certain Disabilities (PDF) Hawaii Tax Forms for Individuals with Certain Disabilities (PDF) An individual who is eligible for Medicaid, TANK, and is receiving SSI may receive a tax reduction on Disability Insurance (DI) payments from state agencies by entering their eligibility information on the disability form. The Social Security Administration (SSA) will issue the tax reduction to the employee on any disability payment received and the agency will have notifies the employee of the amount of the tax reduction. The benefit is available to employees who fall under the same income group as the beneficiary. An individual with the income level that would reduce his or her disability benefits can request a tax credit on income tax due if the individual's disability is certified as severe enough that it prevents the individual from being self-supporting.

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