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Home / How to Apply for Disability Benefits in New York

How to Apply for Disability Benefits in New York

New York State (NYS) disability benefits cover temporary and long-term medical conditions that prevent you from working and earning an income.

Unfortunately, the two plans have huge holes. You will find that the short-term payment amounts are too small and do not last very long – if you have the coverage. Social Security benefits are slightly better and continue longer, but it is much harder to qualify.

Debt settlement programs can help you avoid financial hardship if you did not purchase a supplemental policy in advance to fill these gaping holes.

Follow the outline for help estimating the benefit amount, determining eligibility, finding claim forms, tracking status, and more.

NYS Short-Term Disability (Temporary)

New York State (NYS) short-term disability insurance is a statutory (required by law) program that pays benefits to covered workers. The mandated policy pays claims temporarily (26 weeks) when an eligible medical condition prevents you from working and earning an income.

  1. NYS Short-Term Disability (Temporary)
    • NYS Disability Forms
      • DB-450
      • DB-300
      • C-3
    • NYS Disability Eligibility
      • Family Leave
      • Maternity Leave
    • NYS Disability Amount
      • Debt Relief
      • Supplemental
    • Where to File
    • Claim Status
    • Phone Number
  2. Social Security Disability NY (Long-Term)
    • Benefit Amounts
    • Application Steps

NYS Disability Forms

Completing an application for NYS short-term disability benefits requires several confusing sets of instructions. Follow each step carefully to avoid delaying the receipt of your check – be it ever so small.

  1. Identify the correct claim form to download and complete
  2. Fill it out correctly per the directions
  3. Determine which insurance company to send it to

DB-450

Complete the short-term disability NY claim form DB-450 for any off-the-job accidents and illnesses. Complete this paperwork if you were working no less than four weeks before the start date of your medical event to apply for benefit payments.

Download form DB-450

DB-300

Download and file a short-term disability NY claim form DB-300 if you were unemployed more than four weeks before suffering a covered accident or illness. You cannot receive benefits from both programs simultaneously because the rules are binary.

  1. Unemployment: physically able to work
  2. Disability: physically unable to work

Download form DB-300

C-3

Complete temporary disability NY claim form C-3 if you suffered an on-the-job accident or illness. Workers Compensation covers occupational medical conditions, provides a much higher benefit level. It also may pay for medical care that helps you recover and return to the job.

Download form C-3

NYS Disability Eligibility

NYS short-term disability eligibility requirements fall into two main categories: you have to have the coverage in force, and have a valid medical cause to file a claim.

  1. Many employee classes and organizations are exempt from the statutory contribution requirement. However, employers can elect to participate voluntarily.
  2. Wages lost due to injuries or illnesses that do not arise out of or in the course of employment are viable reasons. File with Worker's Compensation if you hurt yourself on the job – the benefits are much better.
  3. Elective surgery is not a valid reason. You do not qualify while recovering from a tubal ligation, vasectomy, or cosmetic procedure that is not medically necessary.

Family Leave

Workers are not eligible to file claims for short-term disability NY and Paid Family Leave (PFL) at the same time. The two programs cover entirely different causes of lost income.

  • Disability: An employee's medical condition ($170 per week max)
  • Paid Family Leave ($939 per week max in 2021)
    • Bonding with newborn baby, adoption, foster care
    • Care of a sick family member
    • Military family support

Maternity Leave

Many NY women are eligible to file a short-term disability for maternity leave claim before delivery and or after giving birth to their baby. However, once again, the minuscule benefit does not help as much as most new parents need – especially when mom misses extended time from work due to pregnancy-related health problems.

  • Pregnancy disability leave (due to complications) before delivery can last several months
  • Recovery from normal labor and delivery has two ranges
    • 6 weeks: vaginal birth
    • 8 weeks: cesarean section
  • Postpartum medical problems can last indefinitely

NYS Disability Amount

If you are asking how much, the NYS short-term disability benefit amount is paltry. The policy replaces up to 50% of your weekly income, which sounds good on the surface. However, the cap of only $170 per week leaves most applicants well below the 50% limit.

Consider this simple example of actual income replacement levels for average middle-class wage earners under the disability benefits law (DBL).

Annual Income Weekly Earnings Benefit %
$26,000 $500 30%
$52,000 $1,000 15%
$78,000 $1,500 7.5%

Debt Relief

Complete a debt relief application. With the tiny short-term disability NY amount of $170 weekly, it is too easy to fall behind on your bills. People who know that their medical condition is temporary often find that a settlement program helps reduce financial stress.

Debt relief programs are a good fit if you meet these three criteria.

  1. Owe more than $10,000 in unsecured debt
    1. Credit cards
    2. Personal loans
    3. Unpaid medical bills
  2. Expect to resume working shortly to fund an escrow account
  3. Behind on payments to creditors due to financial hardship

Supplemental

The tiny short-term disability NY benefit amount is a great reason to purchase supplemental coverage before becoming sick, hurt, or pregnant. Proactively buying a second policy can boost your income replacement level to percentages that make a difference.

The state benefit offers a false sense of security with a paltry $170 per week maximum. Tell your co-workers to act now to boost their coverage to acceptable levels – before they learn the hard way when filing a claim.

  • Percent of gross income up to 66%
  • Weekly maximum up to $1,500

Where to File

You must file (mail, fax, or upload) the completed NYS short-term disability claim form within 30 days of your medical event. The instructions indicate that you must forward the document to one of three entities.

  1. Your employer if still employed
  2. Your last employer's insurance provider if recently unemployed
  3. Workers' Compensation Board – Disability Benefits Bureau if unemployed for more than 4 weeks (PO Box 9029, Endicott, NY 13761-9029)

People who commute over state lines should follow the claims guidelines according to where they work rather than where they reside.

  • New Jersey
  • Connecticut
  • Pennsylvania
  • Massachusetts
  • Vermont

Claim Status

Contact the NYS short-term disability insurance provider selected by your most recent employer to determine claim status. Speak with the benefits person at your workplace to find the company name, phone number, and address.

Since your employer chooses the insurance company, they should be able to provide this information. In case they cannot, the state maintains an online provider lookup to facilitate claim filing and status verification.

Find the provider directory here.

Phone Number

The first NYS short-term disability phone number to call belongs to your employer's human resource department. Your employer chooses the insurance company. Therefore, they should be able to direct you about where to file your claim and follow up on its status.

The second contact phone number belongs to the New York Worker's Compensation Board. Call (877) 632-4996 for assistance in identifying the issuing insurance company.

Below is a partial list of phone numbers for the most widely used insurance companies. Call the company chosen by your employer.

Company Phone Number
Guardian (800) 268-2525
New York State Insurance Fund (NYSIF) (888) 875-5790
Shelter Point Life (800) 365-4999
The Standard LIC of NY (800) 426-4332

Social Security Disability NY (Long-Term)

New York State also co-manages the Social Security Disability Insurance program with the Federal Government. Two Social Security policies provide income replacement for people with long-term disabilities (not temporary – lasting less than 12 months).

  1. Supplemental Security Income (SSI) covers disabled adults and children who have limited earnings and resources
  2. Social Security Disability Income (SSDI) pays benefits to you and certain family members if you worked long enough and paid FICA taxes

SSI and SSDI have vastly different benefits amounts and application steps.

Benefit Amounts

The Social Security disability benefit amounts for NY residents will vary depending on the program and the income earned while able-bodied and working. What follows are average estimates only. Only your local disability determinations office can provide an accurate number for the size of your pending claims check.

  • SSDI grantees receive from $800 to $1,800 monthly, depending on their previous earnings levels and years paying into the system. The average figure is about $1,200 per month.
  • SSI recipients take in less money each period because they did not pay into the system, and any countable income reduces the benefit.
    • Eligible individual: $783
    • Eligible couple: $1,115
    • Essential person: $392

Application Steps

The steps for applying for Social Security disability benefits in NY are different for the two programs. Begin at the correct starting point to avoid delays in processing your claim. Consult an attorney for help in navigating the process.

  1. Apply for SSDI benefits by completing an online claim form at the federal website. The SSA system will automatically forward the electronic application to a local state office. An analyst from the NYS Division of Disability Determinations will review your case and make a decision.
  2. Apply in person for SSI benefits at a local Social Security office. Make an appointment in advance to minimize the time spent waiting for an agent to help you. You can call or go online to find the office nearest to where you live.
    1. Phone Number: 1-800-772-1213
    2. Online office locator

How to Apply for Disability Benefits in New York

Source: https://www.growingfamilybenefits.com/nys-disability-benefits/