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1.)  Who is eligible for benefits ?



Most wage earners employed in New York State if they are working for a covered employer  (See below)​

- F/T employees who are new to the labor force are eligible after they have worked for (4) consecutive weeks

- P/T employees who are new to the labor force are eligible on the 25th day of regular employment 

- Employees who have been receiving UI benefits are eligible immediately once the begin work if prior employment was with a    

   covered employer

- New employees who have previously established DBL eligibility with another employer are eligible as soon as they begin work, as

   long as the gap is not more than (4) weeks

- Personal or Domestic employees working for the same employer in a private residence at least (40) consecutive hours a week

- The spouse working for a Sole Proprietor of Partnership, unless excluded by the employer

- Employed college students are eligible for DBL if they meet any of the requirements above

- A corporate officer is an employee and will be covered as such unless he/she is a nominal officer or receives no wages or

   remuneration for his/her services 



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2.)  Who is not eligible for benefits ?



- Government, railroad or maritime workers, minor children of employers, golf caddies, or independent contractors

- Ministers, Priests, Rabbis, Sextons, Christian Science readers or members of a religious order

- Person engaged in a professional or teaching capacity in or for a non-profit religious, charitable or educational institution; persons

   receiving rehabilitative services in a sheltered workshop operated by such institutions under a certificate issued by the U.S.

   Department of Labor

- Persons receiving aid from religious, charitable or educational institutions who perform work in return for such aid

- Students in elementary or secondary school who work P/T during the school year or vacation

- Employees during the first 45 days of "extra employment" defined as those not normally in the labor market who may be hired in

   the regular and usual course of business to do work for a limited special period of time

- Employees in "casual employment"; defined as an employee who normally works in a different occupation hired for a day or less

- Corporate Directors acting only a such and not as employees

- Partners & Proprietors are not required but must provide coverage for its employees

- Executive Officers in an incorporated non-profit, religious, charitable or educational institution

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3.)  Benefits (Unemployed)



Unemployed workers who are receiving Unemployment Insurance Benefits and become disabled within (4) weeks from termination of employment, benefits are paid by the former employers insurance carrier.



If an unemployed worker becomes disabled more than (4) weeks but within (26) weeks after termination of employment and is either eligible for or is receiving unemployment insurance, benefits are paid from the 1st day of total disability and unemployment insurance is discontinued.  Unemployed workers are paid by a special fund for disability benefits.



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4.)  Is there a time limit to file a claim ?



YES.  A claimant must file their claim within (30) days after they become disabled.  Claims filed beyond (30) days are not necessarily rejected, but they will not be paid for any disability period more than (2) weeks before the claim is filed; unless they can prove that it was not reasonably possible to file earlier.  The claimant will not receive benefits if the claim is filed more than (26) weeks after the disability begins.



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5.)  Can a claimant appeal be rejected ?

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YES.  A claimant may appeal the carrier's decision directly with the Workers Comp Board within (26) weeks after receiving a notice of denial of benefits.  The Board will examine the case and hold a hearing to determine if benefits should be paid.

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6.)  Taxation of Benefits 

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Benefits are required to be reported as income.  The insurance carrier, acting as a third party payor, is required to withhold FICA from DBL benefits paid within the first (6) months following the onset of disability.





7.)  Are Non-New York employees eligible for DBL benefits ?



​​YES, in some instances.  Eligibility is based on the states in which the employee works.  However employees working outside of New York are covered if their service in not localized in any other state, but some of the service is performed within New York and:



- Employees base of operations is in New York

- There is no base of operations in any other state, but the employee is directed from New York

- The based on operations or place where the service is directed or controlled is not in any state in which some part of the service is

   performed, and the employees residence is New York





8.)  Will an employee lose eligibility if they change jobs or become unemployed ?



If you change from a job with one "covered" employer to another "covered employer", you are protected from the first day on the new job.  If you change to a job in an exempt employment with a "non-covered" employer and work in such employment  for more than (4) weeks, you lose protection until you satisfy the (4) consecutive weeks in a "covered" employer.  Generally, you do not lose protection during the first (26) weeks of unemployment, provided you are eligible for and are claiming unemployment insurance benefits.





9.)  Can an employee receive both DBL and Social Security benefits ?

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YES.  If an employee is entitled to disability benefits, the fact that they are eligible for receiving Social Security benefits does not affect their right to collect DBL.





10.)  Does DBL cover pregnancy and/or pregnancy related disabilities ?



YES.  If an employee becomes disabled due to pregnancy, they can be entitled up to (26) weeks of benefits.  Eligibility for benefits is based on certification of disability.  If an employee is on leave of absence without pay and becomes disabled within (4) weeks of the last day worked, the employee is eligible to collect benefits.  





11.)  Is an employee entitled to benefits for disabilities resulting from an auto accident ?



YES.  An employee injured in an auto accident subject to the No-Fault Law is eligible to receive DBL benefits. No-Fault insurance benefits may be reduced by the amount of disability benefits the employee is eligible to receive. 

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