New York Short-Term Disability Benefits (DBL)

Residents of New York may be eligible for several short-term disability benefit programs designed to protect people who are temporarily unable to work due to injury or illness. For example, certain employees can take time off under the New York Family and Medical Leave Act (NYFMLA). Others may qualify for state short-term disability benefits under the state's Disability Benefits Law (also known as "DBL").

Unlike workers' compensation, New York short-term disability protects workers who are injured or become ill even when they aren't on the job. While short-term benefits are limited both in the amount and number of payments available, they can provide a needed lifeline for people who aren't able to work but don't have private long-term disability insurance or qualify for Social Security. Knowing your rights under the NY short-term disability benefits law can maximize your cash benefits and avoid financial trouble while you recover from your medical impairment.

Who Is Eligible for New York Short-Term Disability Benefits?

You're eligible for NY short-term disability benefits if you were employed (or recently employed) at the time you became injured or ill, but the disabling condition didn't occur while you were at work. (Injuries on the job are covered under different workers' comp rules.) Pregnancy is covered under short-term disability, but elective surgeries are not.

Which Employees Are Covered by the Disability Benefits Law in New York?

New York's disability benefits law covers most—but not all—individuals who work for employers in the state. Short-term disability is available if:

• you're a current employee who has been working at your job for at least four consecutive weeks at a job that's considered to be owned by a "covered employer"
• you're collecting unemployment but recently worked at least four consecutive weeks at a job owned by a covered employer
• you changed from one covered employer to another (as long as the employment is continuous, coverage for short-term disability starts on your first day of work at your new job)
• you're a domestic worker who works 40 hours or more for one employer, such as nannies and personal assistants, and
• you aren't employed by a covered employer but elected for voluntary coverage.

This law applies whether you're a full-time, temporary, or seasonal employee. Because short-term disability is meant to compensate you for loss of income due to a medical condition, you must be receiving medical treatment from a physician, chiropractor, podiatrist, psychologist, dentist, or certified nurse midwife in order to qualify.

Who Is a "Covered Employer" Under New York's DBL?

Pretty much all companies that have one or more employees are considered "covered employers." This includes for-profit businesses such as sole proprietors, partnerships, LLCs, LLPs, and most corporations. Nonprofit organizations are also subject to the short-term disability law, with the following employee exceptions:

• clergy or members of religious orders who are only performing religious duties
• employees of certain religious, charitable, or educational organizations
• people who are working in exchange for charitable aid, and
• compensated executives for certain religious, charitable, or educational organizations.

Independent contractors are not considered employees by definition and as such are exempt from coverage under the NY short-term disability law—although they can opt to purchase disability insurance on their own.

What Agency Handles Short-Term Disability Benefits in New York?

Even though short-term disability benefits cover New Yorkers for injuries sustained "off-the-clock," the New York State Workers' Compensation Board (WCB), part of the state Department of Labor, oversees the administration of short-term disability benefits. Most workers' comp and short-term disability payments are made out of the New York State Insurance Fund (NYSIF).

You can contact the WCB regarding short-term disability insurance for employees who are disabled due to non-work-related illnesses or injuries at (877) 632-4996. You can also contact NYSIF directly if the insurance fund is your company's insurer.

Some employers apply to the Board for an exemption that allows them to self-insure. Self-insured employers pay short-term disability benefits themselves instead of paying for insurance. If your company self-insures, contact them directly to coordinate disability payments.

How Much Can I Expect to Receive in New York Disability Benefits?

Currently, you can receive a DBL cash benefit of 50% of your average wages (calculated over the prior eight weeks) up to a maximum of $170 per week. These payments are subject to Social Security and Medicare taxes. You can receive benefits for a maximum of 26 weeks during any one-year period.

If your DBL claim is approved, you'll start to receive cash benefits on your eighth consecutive day out of work—the first seven days are an unpaid "waiting period." However, there's no waiting period if you've been collecting unemployment for more than four weeks. You'll receive benefit payments every two weeks for up to 26 weeks in a one-year period.

If you're pregnant, short-term disability benefits are available for four weeks before your due date and six weeks after you give birth (eight weeks if you have a Caesarian section). Your leave time can be extended if you have complications during delivery or post-partum, but time off for elective surgeries (like tubal ligation) isn't available.

Keep in mind that you can't collect both DBL benefits and paid family leave or unemployment benefits at the same time.

Who Pays for New York Short-Term Disability Benefits?

Employers pay most of the cost of New York's short-term disability benefits program. Some companies pay the premiums themselves. Others pass a portion of the cost on to employees, withholding up to one-half of 1% of employee wages, up to 60 cents weekly.

Employees who earn more than $120 per week from multiple jobs can ask their employees to split up their contribution amount based on the percentage of their earnings the job represents. But the maximum withholding from all jobs is still 60 cents a week.

Some employers with private short-term disability plans can ask employees to pay more than 60 cents per week if they agree. Under New York state disability benefits law, the employee contribution must be reasonably related to the value of the benefits.

How Do I File a Claim for Short-Term Disability in NY?

You can apply for NY short-term disability benefits by completing Form DB-450, Notice and Proof of Claim for Disability Benefits. You must file this form within 30 days of the first date you became disabled or else you'll risk losing your claim to benefits. Don't submit it before you're disabled either, even if (for example) you're pregnant and know the due date already.

You can get Form DB-450 from your employer or print it out from the Workers' Compensation Board website. Read the instructions carefully. There's an employee section for you to complete, as well as a section your health care provider needs to fill out. You might need to provide medical evidence of your disability for the entire period you're requesting benefits.

If you're employed or have been unemployed for less than four weeks, your employer must complete an additional section. In that case, you'll need to submit Form DB-450 to your company or your company's insurer. You can search for your employer's insurer on the WCB website. If an insurance provider isn't listed, contact the Board. You can reach them at (877) 632-4996 or visit your local WCB office—but call ahead to make an appointment.

If you've been collecting unemployment benefits for longer than four weeks at the time you become disabled, you'll need to mail your completed form DB-450 to the following address:

Workers' Compensation Board
Disability Benefits Bureau
P.O. Box 9029
Endicott, NY 13761-9029

If you've been unemployed for more than four weeks and your disability resulted from a no-fault auto accident or the negligence or wrongdoing of a third party, you'll also need to complete Form DB-450.1, Claimant's Statement Regarding No Fault or Personal Injury. Submit it along with your Form DB-450.

Can You Appeal if Your Claim Is Denied?

The insurance carrier or your employer will send you a Notice of Rejection if your claim for state disability benefits is denied. You should receive the notice within 45 days of submitting your claim. The notice will have instructions on requesting a review by the Workers' Compensation Board.

If you request a review and still don't get benefits, you might want to consult with a disability employment attorney in New York. An experienced employment benefits lawyer can help you gather the information you need to strengthen your claim on appeal, represent you in a hearing in front of the Board, and increase the amount of benefits you'll receive if you win.