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NYS Disability

Why pay more than you have to for DBL?

We can help you start saving money right away; with highly rated, reputable carriers.

The Walsh Group represents many of New York’s highly rated private DBL carriers; companies we are confident will deliver prompt and superior service. As you know, price should not always be the determinant in selecting a carrier. Financial rating, rate stability, claims performance, rate action history for large employers, underwriting philosophy, claims turnaround, reporting capabilities and general work ability with our clients, your employees and our staff can have a great impact on your program. With just a quick call to our office we can complete a DBL application and provide you the following monthly rates:

Businesses with 1-49 Lives

Monthly Equivalent Rates paid annually in advance:

  • Male: $1.75 Female: $3.80
  • Minimum Annual Premium: $75

Interested?

  • Call 716-675-2100 ext. 19 and we’ll take your application over the phone.
  • Upon approval, we will notify your existing carrier of the replacement and we will make sure you are provided with any applicable refunds. Private insurance carriers will refund unearned premium on a pro-rata basis; no penalties will apply. In most cases we can provide you with a binder and a policy number within 24 hours.

Businesses with 50+ Lives: 

For the current and prior 3 years provide us with the following information:

  1. Carrier and policy periods
  2. Annual premium & rates
  3. Annual covered payroll (first $340 per week per employee)
  4. Annual total incurred claims (paid and reserves). Please request currently valued loss runs from your carrier(s).
  5. # of covered males & # covered females per annual period

Monthly rates can be either on an employee composite rate basis, gender based or based on payroll. Covered payroll is the first $340 per week per employee. We will search a number of carriers for the best program for your needs. And if you have 1,000+ employees we can provide you with alternative funding options as well.

Benefit from our experience and longevity in the industry for DBL and other products and services we can offer. Please visit our web site often as we continue to update pricing and offer new products and services.

This following content is a general and simplified overview of Disability Benefits provisions of the Workers’ Compensation Law as provided by the NYSWCB and is provided herein as a convenience for your review. It is not a substitute for the law or legal advice.

About Disability Benefits

Employers with one or more employees are subject to the provisions of the New York State Disability Benefits Law. The law provides for the payment of cash benefits to employees who become disabled because of injuries or sicknesses which have no connection to their employments, and for disabilities arising from pregnancies. In workers’ compensation cases, the cost of medical treatment is borne by the insurance carrier. In disability benefits cases, the law does not provide for payments for medical care.

Introduction to the Disability Benefits Law 

Disability benefits are temporary cash benefits paid to an eligible wage earner, when he/she is disabled by an OFF THE JOB injury or illness. The Disability Benefits Law provides weekly cash benefits to replace, in part, wages lost due to injuries or illnesses that do not arise out of or in the course of employment. Disability benefits are also paid to an unemployed worker to replace unemployment insurance benefits lost because of illness or injury.

An employer is allowed, but not required, to collect contributions from its employees to offset the cost of providing benefits. An employee’s contribution is computed at the rate of one-half of one percent of his/her wages, but no more than sixty cents a week.

If an employee has more than one job at the same time, with combined wages of more than $120.00 per week, the employee may request each employer to adjust the contributions in proportion to the earnings of each employment. The combined contributions may not exceed 60 cents per week. The request should be made as soon as the employee enters a second job.

Disability benefits include cash payments only. Medical care is the responsibility of the claimant. It is not paid for by the employer or insurance carrier.

How to File a Claim

If you are currently employed, or if you have been unemployed for less than four weeks from the date the disability began, file the claim with your employer or insurance carrier, using form DB-450. This form is available on-line, or you may obtain a copy from the nearest district office. Keep a copy of this form to submit again if your claim is not paid promptly.

If you have been unemployed more than four weeks from the date the disability began, file the claim with the Disability Benefits Bureau, using form DB-300.

You must file your claim within 30 days after you become disabled. If you file late, you will not be paid for any disability period more than two weeks before the claim is filed. Late filings may be excused if it is shown that it was not reasonably possible to file earlier. No benefits will be paid if you file more than 26 weeks after your disability begins.

You must be under the care of a physician, chiropractor, podiatrist, psychologist, dentist, or certified nurse midwife in order to qualify for benefits. Your health care provider must complete and sign the “Health Care Provider’s Statement” as proof of your disability.

However, if you depend for healing upon prayer through spiritual means alone in the practice of religion, you must be under the care of a duly accredited practitioner to qualify for benefits. In this situation, the practitioner must complete and sign the “Practitioner’s Statement” (form DB-450.5) before mailing.

Before filing your claim, be sure that you have completed and signed the “Claimant’s Statement” and your health care provider or practitioner has completed and signed his/her portion. Submit this information promptly to avoid delaying your claim.

Cash benefits (DB)

Cash benefits are 50 percent of a claimant’s average weekly wage, but no more than the maximum benefit allowed. The average weekly wage is based on the last eight weeks of employment. If counting the last week in which the disability began lowers the benefit rate, it is not included in determining average weekly wage. Effective May 1, 1989, the maximum benefit allowance for any disability is $170 a week. Benefits paid by the employer or insurance carrier are subject to Social Security and withholding taxes.

Benefits are paid for a maximum of 26 weeks of disability during 52 consecutive weeks. For employed workers, there is a 7-day waiting period for which no benefits are paid. Benefit rights begin on the eighth consecutive day of disability. For unemployed workers who are receiving Unemployment Insurance benefits and who become disabled more than four weeks (but within 26 weeks) after termination of employment, benefits are payable from the first day of the disability that disqualifies them from receiving Unemployment Insurance benefits. An employer must supply a worker who has been disabled more than seven days with a Statement of Rights under the Disability Benefits Law (form DB-271), within five days of learning that the worker is disabled.

Who Is and Who Is Not Covered by the Law (Disability Benefits)? 

Who is Covered?

  • Employees or recent employees of a “covered” employer, who have worked at least four consecutive weeks.
  • An employer of one or more persons on each of 30 days in any calendar year becomes a “covered” employer four weeks after the 30th day of such employment.
  • Employees of an employer who elects to provide benefits by filing an Application for Voluntary Coverage.
  • Employees who change jobs from one “covered” employer to another “covered” employer are protected from the first day on the new job. Generally, an eligible employee does not lose protection during the first 26 weeks of unemployment, provided he/she is eligible for and is claiming unemployment insurance benefits.
  • Domestic or personal employees who work 40 or more hours per week for one employer.

Who is Not Covered? 

  • A minor child of the employer.
  • Government, railroad, maritime or farm workers. Ministers, priests, rabbis, members of religious orders, sextons, Christian Science readers.
  • Corporate officers and persons engaged in a professional or teaching capacity in or for a religious, charitable, or educational institution of a “non-profit” character, and persons receiving rehabilitation services in a sheltered workshop operated by such institutions under a certificate issued by the U.S. Department of Labor.
  • Persons receiving aid from a religious or charitable institution, who perform work in return for such aid.
  • One or two corporate officers who either singly or jointly own all of the stock and hold all of the offices of a corporation that employs no other employees.
  • Golf caddies.
  • Daytime students in elementary or secondary school, who work part-time during the school year or their regular vacation period.
  • Employees who change to jobs in an exempt employment or with a “non-covered” employer, and work in such employment for more than four weeks, lose protection until they work four consecutive weeks for a “covered” employer.

Note: A “non-covered” employer may elect at any time to provide disability coverage by filing an Application for Voluntary Coverage with the Chairman of the Workers’ Compensation Board.