NYS Forms: Applying for Short-Term & Temporary Disability

Many residents wonder how to apply for short-term disability in New York State.

However, your best avenue may not be to submit a DB-450 form because the weekly benefits are minuscule: $170 per week maximum in 2022.

Several other options pay significantly more. Therefore, you might want to learn about these alternative program rules before proceeding.

For instance, new mothers can file for pregnancy disability or submit a claim under the PFL program, which pays up to six times more.

Likewise, temporary disability benefits through Workers’ Compensation also pay up to six times more for on-the-job accidents and illnesses.

How to Apply for Short-Term Disability in NY

People who work in New York State apply for short-term disability benefits after suffering a non-occupational (off-the-job) accident or illness. Follow each step carefully to avoid delaying the receipt of your check – be it ever so minute.

  1. Identify the proper claim form to download
  2. Complete the paperwork correctly per the directions
  3. File the form with the appropriate authority
  4. Call the correct phone number to follow up

Short-Term Forms

You have several possible forms to complete when applying for short-term disability in New York State after a non-occupational loss. Choose the correct document to complete and submit the paperwork to the appropriate authority to avoid unnecessary delays.

DB-450 Form 2022

Download 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

PFL 1 & 2 Forms 2022

Download and file the PFL 1 & 2 forms instead of applying for a short-term disability during maternity leave in New York State to increase your weekly benefit dramatically.

New York Short-Term Disability for pregnancy replaces only 50% of income and maxes out at a puny $170 per week. Meanwhile, the Paid Family Leave program is far more generous, replacing 66% of earnings and paying up to $1,068 weekly – more than six times more!

New mothers can choose which program to utilize while they recover from labor and delivery (disability) and bond with their newborn baby (Paid Family Leave).

Download Forms PFL 1 & 2

Commuter Forms 2022

Residents who commute across the border for their jobs should not complete any NY short-term disability form when applying for benefits because they do not have the coverage. The relevant law applies where you work, not where you live.

Instead, download and complete the paperwork for the state where you work – if it has a mandated program.

Where to File

Sending the completed forms to the proper authority is the second critical step when applying for short-term disability benefits.

Actively Working

File the claim document with your employer or insurance company if your disability started within four weeks of the last day you worked. Your Human Resources department should be familiar with the process.

Search for your employer’s insurance policy online if you encounter problems getting the correct information from your employer. Small businesses deal with this issue less frequently.

Collecting Unemployment

File the claim paperwork with the Workers’ Compensation board if you were collecting unemployment benefits and your disability started more than four weeks from the last day you worked.  

Mail the completed form to the following address.

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

Phone Numbers

Following up with a phone call to the appropriate authority is sometimes the third critical step when applying for short-term disability benefits in New York State. You might need to speak with a customer service agent to clarify requests for further information.

Choose the New York State short-term disability phone number corresponding to your employment status when you suffered an off-the-job accident or illness.

  • Collecting Unemployment: Call the Workers’ Compensation Board at (877) 632-4996
  • Actively Working within four weeks: Call the insurance company selected by your employer, which could be one of the following.
    • 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

How To Apply for Temporary Disability in NY

People who work in New York State apply for temporary disability after suffering an occupational (on-the-job) accident or illness. Workers’ Compensation offers benefits in three areas, making an effort more worthwhile.

  • Healthcare to treat injured workers
  • Partial lost wage replacement
  • Survivor benefits if workers die

Temporary Disability Forms

Applying for temporary disability benefits in New York after an on-the-job injury or illness could mean completing many different forms. However, the higher level of lost wage replacement offsets the onerous paperwork requirements.

% MaximumWeekly LimitDuration
Short-term disability for non-occupational losses50%$17026 Weeks
Temporary disability for occupational losses66%$1,125Indefinite

As you can see, the maximum weekly benefit is 6.6 times higher for on-the-job incidents compared to those that happen off-the-job. Plus, Worker’s Compensation pays your doctor bills for treatment.

Find the thirty-plus Worker’s Compensation forms here.

Temporary Disability Claims

Follow specific steps when applying for temporary disability benefits after an on-the-job accident to avoid delays or rejection of your claim.

  1. Notify your employer within 30 days of the injury or illness
  2. Report the incident to the NY Workers’ Compensation Board as soon as possible using form C-3 for employee claims

Also, consider hiring an attorney to represent your case, as workplace injuries and diseases are challenging to prove. The significant benefits could outweigh the legal fees.