New York Short-Term Disability Benefits (DBL)

If you're injured or you become ill while not on the job, you might be eligible for New York State short-term disability benefits under its Disability Benefits Law (DBL). While DBL benefits are limited both in amount and the number of payments, they can be very helpful in providing cash to those who are temporarily unable to work.

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

To be eligible for short-term disability benefits, you must have become injured or ill while not at work, but you must be employed or recently employed at the time of illness or injury. (Those injured on the job are covered under different workers' compensation rules.) Pregnancy is covered under short-term disability, but elective surgeries are not.

Which Employees Are Covered by Short-Term Disability in New York?

New York's disability benefits law covers most individuals who work for employers in the state, but not everyone. The employees who are covered by short-term disability include:

• individuals who are currently working and have worked at least four consecutive weeks at a job that's considered to be owned by a "covered employer"
• individuals who recently worked at least four consecutive weeks at a job owned by a covered employer and who are collecting unemployment
• individuals who change from one covered employer to another covered employer (as long as the employment is continuous, coverage for short-term disability starts on your first day of work at your new job)
• domestic workers who work 40 hours or more for one employer—for example, nannies and personal assistants, and
• individuals who aren't employed by a covered employer but elect for voluntary coverage.

What Is a Covered Employer Under New York SDI Rules?

The definition of covered employer generally includes all employers with one or more employees. Employees excluded from this definition includes the following:

• government workers
• religious leaders
• those providing work in return for charity care, and
• high school students who work part-time or only during vacations.

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

The New York State Workers' Compensation Board, under the New York State Department of Labor, oversees short-term disability benefits. New York State law requires that every covered employer provides insurance to cover short-term disability benefits for their employees. Under the Workers' Compensation Board, the New York State Insurance Fund (NYSIF) provides insurance to a vast majority of employers in New York State.

The New York State Workers' Compensation Board can be contacted regarding short-term disability insurance for employees who are disabled due to non-work-related illnesses or injuries at (518) 462-8881 or (800) 353-3092. NYSIF can be contacted directly if the insurance fund is your employer's insurer.

Another option available to employers is to 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?

New York DBL disability benefits will pay 50% of your average wages (calculated over the prior eight weeks) up to a maximum of $170 per week.

Benefits will begin on your eighth consecutive day out of work; the first seven days are an unpaid waiting period. 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 52-week period.

For pregnancy, women are covered for four weeks before their due date (if they can't work for medical reasons) and six weeks after a normal pregnancy (eight weeks after a Caesarian section). Your leave time can be extended if you have complications. Women filing for disability based on pregnancy or childbirth receive the same payment amounts as those filing for other disabilities.

New York's short-term disability insurance doesn't cover medical costs.

Who Pays for NYS DBL Benefits?

Employers pay most of the cost of New York state's short-term disability benefits program. Some employers 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?

If you become disabled and qualify for New York's short-term disability insurance benefits, you must file your claim within 30 days of becoming disabled. You start a claim by completing a "Notice and Proof of Claim for Disability Benefits," Form DB-450. You can get the form from your employer or print the form from the Worker's Compensation Board website.

There's an employee section for you to complete, as well as a section to be filled out by your treating physician regarding your disability. Medical evidence of your disability might be required 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.

If you're working—or are recently unemployed and have been collecting unemployment benefits for less than four weeks when your disability began—you'll submit NYSIF Form DB-450 to your employer or your employer's insurer. You can search for your employer's insurer on the WCB website.

If your employer's insurance provider isn't listed, contact the Worker's Compensation Board. You can call the WCB at 800-353-3092 or visit your local WCB office.

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: Workers' Compensation Board, Disability Benefits Bureau, PO Box 9029, Endicott, NY 13761-9029.

If you're unemployed longer 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. Submit it 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 must 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.