What Is Short-Term Disability in NY State?
New York state has a temporary disability insurance program requiring employers to provide short-term disability insurance for employees. What this means is that employers are required to provide at least partial wage and income replacement, for up to 26 weeks, to eligible employees who are temporarily unable to work due to disability. Some of the most common reasons for employees to ask for short-term disability leave in NY are an injury (work-related injury or not), or illness or injury that prevents an employee from being able to participate in full-time work. Pregnancy and childbirth are also covered under the law and extremely common reasons to claim short-term disability in New York.
If you work in New York state and experience an off-the-job injury or illness, coverage for disability must be given to you through your workplace. Your employer offers those benefits and insurance through a disability benefits insurance carrier who is either authorized by the New York State Workers' Compensation Board or by a small business who decides to write their own policies.
If you are unable to work (or lose your job) due to pregnancy or illness or injury, you will be considered "disabled" under the details of your disability policy and be eligible to earn temporary cash benefits. Your expenses related to medical care, however, are up to you to pay. 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 and an employer must supply a worker who has been disabled more than seven days with a Statement of Rights under the Disability Benefits Law, within five days of learning that you have become disabled.
You may or may not have been paying into your disability benefits plan. Employers are allowed, but not required, to collect contributions from its employees to offset the cost of providing benefits. If you have been contributing to your disability insurance, you cannot be expected to contribute more than one-half of one percent of your wages or sixty cents per week.
If an employee has more than one job at the same time, with combined wages of more than $120 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.
What If I'm Pregnant And Interested In Short-Term Disability Payments?
Currently, pregnancy and the postpartum conditions that render you unable to work qualify you for short-term disability benefits. This is the case even though you would not normally think that these are situations where you are "disabled." However, on March 31, 2016, New York State’s legislature approved paid family medical leave for up to 12 weeks effective 2018. Here's our summary of the coming New York state family paid leave provisions. This means that starting in 2018, you will be able to receive some payment during your maternity or parental leave if you're a NY state employee.
Until 2018, if you are employed in New York, you will not receive paid paternity leave or maternity leave benefits from the state government for bonding purposes after the birth of your child. However, you are entitled to receive some payments during the time you are (a) pregnant, and (b) immediately after birth if you are temporarily unable to work.
New York state gets a "B" grade from the National Partnership for Women and Families when it comes to how favorable the state laws for new and expecting parents compared to other American states.
How does this work? Under New York law, private sector employers (i.e. not government employees) are required to provide disability insurance benefits for their employees to cover any time they are not able to work due to illnesses or other reasons (not including injuries or illnesses that are work-related because those are covered under worker's compensation insurance).
In other words, the inability to work because you are pregnant with complications or immediately after childbirth counts as a short-term disability under private sector employer's insurance policies that most are required to carry under state law. Short-term disability insurance benefits require a medical provider to supply a written determination that you are unable to work due to your condition.
While it is maddening that the government equates such a normal biological event such as childbirth to a "disability", this is simply the term that's applied in the insurance world when it comes to the impact your pregnancy and postpartum medical condition has on your potential ability to work.
Who is Covered by Short-Term Disability in New York State?
The vast majority of private-sector employees are covered in New York state. There is no employer size cut-off as there is under the federal laws and FMLA. There are also far more lenient qualification rules when it comes to how long you must have worked at a "covered" employer.
For example, if you've worked at least 4 consecutive weeks as an employee for a NY state private employer, you meet the tenure requirements. Even if you've switched jobs from one "covered" employer to another "covered" employer — you start enjoying the benefits to short-term disability laws from the first day at your second "covered" employer.
So who is a covered employer? There is an itemized list of exempted employers on the New York state disability website (e.g. priests, sole proprietors, farm workers, rabbis, etc) but the fact that the exceptions are so clearly laid out means that it's very likely most private sector employees are covered.
How Do You File a Claim for NY State Disability Wages?
Claims for disability payments must be requested via a form your employer calls a DB-450 form. Instructions regarding how to file a claim is available here.
Some fine print: you may not preemptively file a claim for disability because you anticipate you will not be able to work due to childbirth or pregnancy conditions.
You may not file a claim for disability payments until you are actually unable to work and there is also a deadline to file within 30 days of the time you are unable to work. The claim form requires a medical provider provide a diagnosis and estimates a date upon which you will once again be able to work.
How Much (and When) Will You Get Paid?
It is better than nothing, but don't expect to make a fortune off of your disability wage payments. The current maximum you will receive is 50% of your last 8 weeks average gross wages up to a maximum of $170 per week.
Starting on the eighth day after you begin your disability you will begin receiving benefits. The first seven days of disability are considered a waiting period where you will not receive your benefits. You may receive the benefits after this period assuming you filed your form DB-450 in a timely fashion. Thereafter, you receive benefit payments every two weeks.
You can get paid for the waiting period, however, if your disability exceeds three consecutive weeks.
How Long Will You Receive Benefits?
Since this is a work-disability payment, the duration of your benefits depends on when your medical provider's assessment of how long you will not be able to work. That said, the typical post-birth disability period that is prescribed is 6 weeks for a normal delivery and 8 weeks for a C-section birth. The maximum benefit anyone can receive under NY state disability benefits is 26 weeks in any 52 week period.
How Long Can You Legally Take Maternity Leave?
In New York State, maternity leave is covered under FMLA and the New York State Maternity Leave Law (PFLL). FMLA allows for 12 weeks of unpaid leave after welcoming a new child through childbirth, adoption, or foster care. Under the New York State Maternity Leave Law, you may be eligible for up to eight weeks of paid leave.
You can not take PFLL and FMLA leave — a federal law that allows for paid family medical leave — at the same time. But if you are eligible for FMLA after taking PFLL leave, you may take it once you used up your time.
What Do You Need To Know About The 2018 New York State Maternity Leave Law?
Starting in 2018, when you take maternity leave, you will get part of your salary replaced by the state. And this is not just restricted to family leave or parental leave based on pregnancy and childbirth or adoption. The new Paid Family Leave Law (PFLL) can also be used for medical leave and sick leave to take care of a sick family member or someone in the military.
Once it goes into effect in 2018, individuals will be entitled to eight weeks of partially paid leave to use as maternity leave, paternity leave, or to take care of an ill family member. If an employer already offers paid leave as opposed to unpaid leave, you will receive whichever pay is greater. In 2019, the amount of partially paid leave is expected to increase to 10 weeks, and 12 weeks in 2020.
During the first year, employees taking this leave will receive 50% or a worker’s average pay. By 2021, this percent is expected to rise to 67%. And to be clear, this is based on the average wage earned by workers in New York, not an individual’s wage.
This leave can’t be taken until after the child is born or adopted. But this family leave can be taken in its entirely, or only partially. And it requires all private employers to opt in.
Families will be happy to know that this parental leave law still includes benefits, and the pay is already taxed.
This new law goes into effect January 1, 2018. To apply, you must fill out paperwork for your employer who will then submit it to their insurance provider. You will be approved or denied within 18 days, and will receive your money via direct deposit or a check — your choice!
The new law will be funded using a formula set by the New York State Superintendent of Finance.
Follow this link if you want to learn more about the upcoming New York state maternity leave law.
Disclaimer: We tried very hard to summarize what the high level points we think you should know if you're a pregnant, working woman in New York. However we're not attorneys and we don't claim to have covered every single detail, so please check New York's State's website for more information and any updates, please see NY state's website.