New York State Disability Insurance Policy Information
New York State Disability Insurance. Employers in New York State are required by law to provide disability benefits for all employees. If your business has one employee or more you are required to cover them all whether they are full or part-time employees. Disability is considered any off-the-job injury or illness that keeps an employee from performing regular work duties.
If an employee is injured so that they cannot work, the insurance pays out a cash benefit directly to the employee. Medical costs are not covered under this policy and are paid out-of-pocket by the employee. If the employee chooses, they can use the New York state disability insurance cash benefit toward medical expenses.
New York State Disability Insurance (DBL) is required for NY employers to provide disability benefits to all eligible employees. Get a fast and free quote today.
Two Ways to Comply with the New York Disability Benefits Law
Employers can cover the cost of NY disability insurance for employees in two ways:
Purchase A Disability Policy: Many employers elect to purchase a policy from a New York State approved list of providers and pay premiums directly to the insurance carrier. Employers may pay the entire premium or choose to have employees contribute to the coverage. Employees contribute through payroll deduction a percentage of 1/2 of 1% of their paid wages but no more than 60 cents per week.
Of course, the employer may waive all employee contributions. The business bears the cost of providing benefits over the amount collected from employees
Establish A Self-Insured Fund: A large business may choose to self-insure by applying to the State Chair for approval as a self-insured employer. Once approved, the business deposits securities or files a surety bond.
Whichever option your business chooses, you must comply with the law and implement disability benefits for employees. Organizations like religious, charitable, or educational institutions that operate on a non-profit basis are also required to provide disability benefits in the same manner if they employ one or more individuals.
Who Is Covered Under New York State Disability Insurance
Your business as the employer covers one or more employees who work for you in each 30 day period during a calendar year. After 30 days of employment, you as the business much cover the employees. Your business is called a "covered" employer.
Employees who change jobs from one "covered" employer to another are covered from the first day on the job without the 30 day waiting period. In addition, an eligible employee does not lose New York state disability insurance protection during the first 26 weeks of unemployment if they are claiming unemployment benefits.
Domestic workers who work in the home are also protected under the New York disability benefits law (DBL). This means you must provide New York state disability insurance benefits for home workers even if you do not personally consider your home a business.
The New York State Disability Law (DBL) provides for a number of instances where employees are not required to be covered. Check the law if you feel your business has workers who are exempt from New York state disability insurance coverage, for example: minor children, ministers and rabbis, railroad workers, corporate officers who hold majority stock positions, and others.
New York State Disability Insurance Cash Benefits
Benefits are paid to disabled workers either through the insurance provider or through the self-insured funds of the employer.
The benefit amount is 50% of the claimant's average weekly wage based on the last eight weeks of employment up to the maximum benefit of $170 a week after a 7-day waiting period. The benefit is paid for a maximum of 26 weeks during a consecutive 52-week (one year) period.
In addition, the business must supply a Statement of Rights under the Disability Law to each worker who has been disabled over seven days. This Statement must be supplied within five days after the employer learns of the disability.
Penalties For Noncompliance With The Disability Benefits Law (DBL)
Employers, including those who employ home workers, suffer penalties if they are out of compliance with the New York disability benefits law:
- The Insurance Board imposes a penalty of 1/2 of one percent of the employer's entire payroll during the period of noncompliance. In addition, there is a $500 fine for each period of noncompliance. (Section 220 (2) of the Disability Benefits Law)
- Failure to secure required disability benefits insurance is a misdemeanor. The punishment is a minimum fine of $100 up to $500 or imprisonment for up to one year or both. A second violation within five years results in steeper fines of not less than $250 or more than $1,250. A third violation can result in a fine up to $2,500. (Section 220 (1) of the Disability Benefits Law)
- In addition to the above penalties, the employer is liable for either the total value of any disability benefits claims paid by the State under the Special Fund for Disability Benefits while the employer was noncompliant. Or, the employer is liable for one percent of the employer's entire payroll during the period of noncompliance, whichever sum is greater.
Common Questions About The Disability Benefits Law
The following info comes from the DBL website:
Q. What is a "day of disability?"
A. A "day of disability" is one on which the employee was prevented from performing work because of disability and for which he/she has not received regular wages or remuneration.
Q. If an employee engages in work for remuneration or profit, even if done at home, while disabled, is he/she eligible for disability benefits?
A. No. As long as he/she is performing any kind of work for remuneration or profit, he/she is ineligible to receive benefits.
Q. Are the costs of medical care included?
A. No. Costs of medical care are not included under the statutory provisions of the Disability Benefits Law. However, where an employer or a union or association plan has been accepted as complying with the law, the worker is entitled to the benefits as described by the plan. Contact your employer to find out if it provides or participates in such a plan.
Q. May an employer/insurance carrier have an employee claiming benefits examined by a health care provider designated by the employer/carrier?
A. Yes. The employee must submit him/herself at intervals, but not more than once a week, to such examinations if requested. Exams are not paid for by the employee and are held at a reasonable time and place. Refusal to submit to an exam may jeopardize a claimant's benefits.
Q. After a claim is filed, how soon will it be paid?
A. If a claim is properly completed with the required statements, the first payment should arrive within four business days after the 14th day of disability or four business days after the receipt of the claim, whichever is later. Benefits are payable every two weeks during the period of disability.
Q. Can a claimant collect Unemployment Insurance and Disability Benefits for the same period of time?
Q. If an employee quits his or her job, may that employee receive Disability Benefits?
A. Termination of employment may affect an employee's right to Disability Benefits.
Q. Can a claimant collect Disability Benefits for disability caused by pregnancy?
A. Yes. If she is disabled because of pregnancy, she may be entitled to up to 26 weeks of benefits. Disability can occur at any time during pregnancy.
Q. What determines disability due to pregnancy?
A. Disability can only be determined and certified by a physician or certified nurse midwife through the submission of medical reports. If a claimant becomes disabled more than four to six weeks prior to the anticipated birth date, or is disabled more than four to six weeks after the actual birth date, more detailed information regarding the disability may be required. The medical reports should describe specific symptoms, rather than just general prognosis. Note: An elective sterilization procedure will not extend the payable period of disability, since benefits are not payable for any period an individual is unable to work due to elective surgery.
Q. Can an employee collect disability benefits if on maternity leave?
A. Yes. If she is on a leave of absence without pay (i.e. maternity leave), and becomes disabled within four weeks of the last day she actually worked, she is entitled to benefits from the employer/carrier (if otherwise eligible). If the disability begins more than four weeks from the last day actually worked and she is claiming/receiving Unemployment Benefits, she is entitled to disability benefits from the Special Fund for Disability Benefits (if otherwise eligible).
Q. Is there a limit on the number of weeks a claimant can receive benefits?
A. Yes. There is a limit of 26 weeks of benefits during a period of 52 consecutive calendar weeks or during any one period of disability. The amount of benefits a claimant receives is dependent upon the length of time he/she is actually disabled as certified by a physician. (If an employer has a separate Disability Benefits Plan, more than 26 weeks of benefits may be paid, if so specified).
Q. What if a claimant is still disabled, but benefits have stopped?
A. If he/she received less than 26 weeks of benefits, is still disabled, and has not received a Notice of Rejection, he/she must submit further medical evidence to his/her employer, insurance carrier or the Special Fund for Disability Benefits. If he/she has received a Notice of Rejection, the claimant may request a review of the rejection by completing its reverse side and mailing it to the Disability Benefits Bureau at the Workers' Compensation Board.
Q. Is a claimant entitled to Disability Benefits for an injury incurred in an auto accident?
A. Yes. However, the amount of the disability benefits may reduce any no-fault insurance benefits the claimant is eligible to receive.
Q. If a claim is rejected or not paid, may it be reviewed?
A. Yes. If a claim is rejected or not paid, the employee should complete the reverse side of the Notice of Rejection (sent by the employer/carrier/the Special Fund, within 45 days of its receipt of the claim) and mail it within 26 weeks to the Disability Benefits Bureau. The address is located on the back of the rejection notice, and in the back of this brochure. Where necessary, the Board will obtain further information and may hold a hearing on the claim. Benefits will be paid if a claim is determined proper and valid.
Q. If a claimant is entitled to or receiving Social Security Retirement Benefits, may he/she still receive Disability Benefits?
A. Yes. If he/she is entitled to Disability Benefits, the fact that he/she is eligible for or receiving old-age insurance benefits under the Social Security Act does not affect his/her right to Disability Benefits.
For more info, visit Introduction to the Disability Benefits Law on the NY State Workers Compensation Board website.
NY State Disability Insurance
As you can see, not complying with disability benefits law in the State of New York can result in significant financial fines in addition to the possibility of serving time in jail. You can request a free quote on this page.
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