Coverage Options
  • Adding in-hospital coverage to the statutory benefit level may increase the maximum benefit to $340/week!*
  • 1.5-times DBL pays 50% of salary (just like Statutory DBL) to a maximum benefit of $255/week.
    Adding in-hospital coverage may increase the maximum benefit to $425/week!*
  • 2-times DBL pays 50% of salary (just like Statutory DBL) to a maximum benefit of $340/week.
    Adding in-hospital coverage may increase the maximum benefit to $510/week!*
  • 3-times DBL pays 50% of salary (just like Statutory DBL) to a maximum benefit of $510/week.
    Adding in-hospital coverage may increase the maximum benefit to $680/week!*
  • 4-times DBL pays 50% of salary (just like Statutory DBL) to a maximum benefit of $680/week.
    Adding in-hospital coverage may increase the maximum benefit to $850/week!*
  • 5-times DBL pays 50% of salary (just like Statutory DBL) to a maximum benefit of $850/week.
    Adding in-hospital coverage may increase the maximum benefit to $1020/week!*

In-hospital DBL Rider:

  • No waiting period – basic DBL benefits are paid from the first day of hospitalization.
  • After 7 days of hospitalization, basic DBL benefits are doubled while an employee is hospital-confined.
  • As with statutory coverage, benefits are paid for a maximum of 26 weeks of consecutive disability.

**new higer benefits!** AD&D Rider

  • Available benefit levels: $35,000 and $70,000.
  • The benefit level for covered dismemberments is 50% of the death benefit.
  • Although DBL only provides benefits for lost wages from illnesses and injuries that are not job-related, the AD&D rider provides 24/7 coverage.
Special Remarks
  • Annual minimum premium: $125 for policies billed annually in advance (groups 1-49 lives). Quarterly minimum premium: $35 for policies billed quarterly (groups 11-49 lives).
  • New, simple rate structure (voluntary insureds and proprietors/partners now enjoy the same low rates as employees)
  • AD&D: Full participation is required for those covered under DBL. The AD&D premium is not included in the DBL premium. For policies with minimum premium, AD&D is in addition to the minimum premium.  
Underwriting Requirements
  • Flat rates for groups of 1-49.
  • Policies can be backdated to a maximum of 30 days.
  • Groups of 50+ employees are experience rated. The following information is helpful to compute a custom quote:
    • Claims experience (“Third-Party Sick-Pay Report” from the policyholder and “Loss Run” from the current DBL carrier)
    • A copy of the most recent, paid premium bill
    • Evidence of a rate increase (if any)
FAQs

This is a small selection of our FAQs with abbreviated answers. For detailed FAQs, please visit our FAQs for employers.

What is DBL?

DBL stands for “Disability Benefits Law” (Article 9 of the Workers' Compensation Law). This statutory disability insurance is mandated by the State of New York. Virtually all employers have to provide DBL coverage for their employees; and the State sets the benefit level.
While Workers' Comp regulates benefits for on-the-job injuries and work-related illnesses, DBL provides payments for eligible wage earners who cannot work due to an illness that was not caused by their job or a disability from a nonoccupational injury.


When does my business have to provide DBL coverage?

If your business qualifies as a “covered employer”, you must provide DBL for all your eligible employees.


When is my business considered a “covered employer”?

Your business becomes a “covered employer” four weeks after it has employed at least one person for any 30-day or longer period in New York in a calendar year (WCL §202).

Additional provision for employers of personal/domestic employees in a private home: You must employ at least one person who works 40 or more hours per week for that one employer.


Which employees do I have to cover?

You must cover all eligible employees. Any person providing services to your for-profit business can be deemed an employee and must be covered under DBL if they are eligible (see Who is not covered under DBL? for exceptions). If your business meets any of the criteria and the person you are hiring is not in an exempt category of an Independent Contractor or in the list of ineligible individuals, you must provide them with DBL coverage.
Therefore, the following employees must be covered:

  • Employees or recent employees of another covered employer, who have worked at least four consecutive weeks for one or both of the employers.
  • Part-time employees, i.e. persons who work fewer hours than constitute your normal workweek. (Any part of a day worked is counted as a day of employment, and the employee becomes eligible on the 25th day of such regular, part-time employment.) (see Who is not covered under DBL? for exceptions)
  • Personal or domestic employees working for you in a private home at least 40 hours a week (if they work 30 or more days in a calendar year for you). 

For coverage regulations regarding business owners see Are business owners covered under NY DBL?


Who is not covered under DBL?

  • A minor child of an employer
  • Government, railroad, maritime, and farm workers
  • Ministers, priests, rabbis, imams, sextons, Christian Science readers, or members of a religious order
  • Executive officers (i.e. president, vice president, secretary, or treasurer) of an incorporated religious, charitable or educational institution
  • Teachers or other professionals working for a religious, charitable or educational institution
  • Volunteers nonprofit organizations who don’t receive any compensation (compensation includes stipends, room and board or any other perks of monetary value)
  • Persons participating in and receiving rehabilitative services in a sheltered workshop run by a religious, charitable or educational institution under a US Department of Labor certificate
  • Recipients of aid from a religious or charitable institution who perform work for the institution in return for the aid.
  • Golf caddies
  • Daytime students in an elementary or secondary school who work part-time
  • "Extra Employees" (so identified because they are normally not in the labor market but are hired to do work for a limited, special period of time; after 45 days, however, they become eligible)
  • "Casual Employees" (so called because they normally work in a different occupation and are hired for a day or less)

For coverage regulations regarding business owners see Are business owners covered under NY DBL?


Are our 1099ers eligible for DBL coverage?

True independent contractors and subcontractors are not considered employees under the NYS Disability Benefits Law and are therefore not covered under DBL. However, whether the labor is paid using a W2 or 1099 Form for tax purposes does not matter in determining an employer-employee relationship for DBL (Workers' Compensation Law) purposes. The Workers’ Comp Board developed specific criteria to distinguish independent contractors from employees.


Are business owners covered under NY DBL?

1. Owners/shareholders of Corporations (C-Corps, S-Corps, and Professional Corporations, for example) are considered employees of the corporation and are automatically covered under NY DBL at the same rates as other employees if there are: 

  • 3 or more officers/shareholders
  • one or two officers (each owning at least one share of stock) with employee(s) (they may choose to exclude themselves from coverage by filing form DB-212.3 pdf icon.)

2. Owners/shareholders of the following types of businesses are not considered employees and are therefore excluded from NY DBL coverage by default:  

  • Partnerships, LLCs, LLPs (with or without employees)
  • Sole Proprietorships
  • Corporations with only one or two officers (each owning at least one share of stock) and no employee(s). (They may obtain coverage (at voluntary rates) by completing form DB-135 pdf icon (for non-contributory groups) or DB-136 pdf icon (for contributory groups).

Can I choose not to provide DBL as a “covered employer”?

No. DBL is mandatory insurance that you must provide for all your eligible employees. If you fail to put a policy in place, you may be subject to fines and other measures.

However, you may file a request with the WCB to exclude certain employees only under the following circumstances:

  • As the business owner, you may choose to exclude yourself: If your business is a corporation with no more than two corporate officers (each owning at least one share of stock) and you have at least one employee, you may elect to exclude yourself from coverage by completing form DB-212.3 pdf icon.
  • You may elect to exclude your spouse by filing a spousal exclusion form DB-212.5 pdf icon (12 NYCRR §355.2)

Are my employees who live outside New York and work in my New York-based office covered?

If they’re eligible, yes. Coverage is based on where an employee works, not where the employee lives.


Our business is located outside New York but some of our employees perform work in New York. Do we need DBL?

If you are an out-of-state employer, you need a DBL policy for your New York employees if you employ one or more individuals each for at least 30 days in a calendar year in New York State.


When do we need which Certificate? What is each Certificate for?

  • DB-120 (Posting Notice, “Blue Board” or DBL Poster): must be posted in a visible place at your work site.
  • DB-120.1 (Certificate of Insurance): is needed to apply for/retain business permits and licenses.
  • DB-820 (Certificate of Insurance): is filed by the carrier with the State to verify the status of a policy.

Are there any consequences if we don’t have a DBL policy as a covered employer?

If you don’t provide DBL coverage as required by law, the Workers’ Compensation Board may investigate and take action. Sole proprietors, partners of a partnership, as well as the President, Secretary and Treasurer of a corporation may be held personally liable for the failure to obtain a DBL policy.

Disability Benefits Law:

§220: Possible penalties if you don’t comply with the DBL coverage requirements

  • §220(2): The Board has the right to impose a penalty based on the amount of the employer’s payroll during the time the employer does not have required DBL coverage (0.5% of payroll during that period). An additional fine for each period of noncompliance may also be imposed.
  • §220(1): If you do not have the required DBL coverage, you may be subject to a monetary fine and/or imprisonment for up to 1 year. Subsequent violations may result in increased fines.

§213(1): Liability for claims

  • Additionally, you may be liable for either the total value of any disability benefits claims paid by the Special Fund for Disability Benefits during the period of noncompliance or one percent of the payroll during the period of noncompliance (whichever is greater).

Please visit the Workers Comp Board’s website for details about possible fines.


Are there any specific compliance regulations for out-of-state businesses with DBL?

Obtaining Government-issued permits, licenses and contracts in New York
If you are an out-of-state businesses requesting a permit/license or if you are seeking to enter into contracts in New York State, you must provide a DB-120.1 (Certificate of Insurance) to the government entity you are dealing with.
 

 

This online information is illustrative only, providing a general overview of the services described. It is not a contract. Please refer to the policy for provisions, conditions, and exclusions. No guarantee is made concerning the accuracy and completeness of the representations of the law made in this section. For legally binding information, please refer to the corresponding section of the Workers' Compensation Law, the “Employer Handbook” published by the Workers’ Comp Board or the Board’s website First Rehab Life 1999-2009.

 


For detailed FAQs, please visit our FAQs for employers.
To see what questions your employees may have, visit our FAQs for employees/claimants.

Claims Guide

When are my employees eligible to file for DBL benefits?

If they are
1. an eligible employee suffering from a disability or illness due to an off-the-job injury; and
2. under the care of a licensed or certified physician, podiatrist, psychologist, chiropractor, or nurse-midwife.

What about former employees who are now unemployed?

They may still file for DBL benefits. If their disability occurs within four weeks after their employment is terminated, benefits are paid by your insurance carrier. If they become disabled in the period between 4 and 26 weeks after termination, they receive benefits from the Special Fund for Disability Benefits, which is administered by the Workers' Compensation Board (see How do I apply for DBL benefits? for details).

Can they collect Disability and Unemployment Insurance benefits simultaneously?

No, they cannot collect Disability and Unemployment Insurance benefits for the same period of time.

What if the disability was caused by a car accident?

They may file for DBL benefits if the disability results from an automobile accident – although No-Fault automobile insurance benefits may be reduced by the amount of disability benefits they are eligible to receive.

What if they’re receiving Social Security Retirement benefits?

They are eligible to file for DBL benefits even if they are receiving (or are entitled to receive) retirement benefits under the Social Security Act. Under these circumstances, however, they may elect to waive their rights to DBL coverage by filing such a request with the Workers' Compensation Board.


What if my employee’s disability is caused by a pregnancy?

Your employee is eligible to file for DBL benefits if her disability is pregnancy-related (based on medical certification of disability). Please note the following guidelines for pregnancy-related disabilities:

  • Pregnancy disabilities are treated the same as any other disability.
  • A health care practitioner – a medical doctor (MD) or a certified nurse midwife (RN-CNM) – must authorize the period of disability.
  • Duration guidelines (in accordance with the American College of Obstetrics and Gynecology);
    • 2 weeks before the expected delivery during an uncomplicated pregnancy
    • 6 weeks after uncomplicated pregnancy with a normal delivery.
    • 8 weeks after uncomplicated pregnancy with a C-Section.
Can my employee receive DBL benefits during her maternity leave?

Pregnancy disability is not maternity leave! Maternity leave itself is not covered under DBL. But a pregnancy-related disability that occurs during maternity leave is covered. If the employee becomes disabled while on unpaid maternity leave, she is eligible only within the four-week period following her last day of employment. If her disability begins more than four weeks after the last day of her employment and she is claiming/receiving Unemployment Benefits, she is not entitled to DBL benefits from the Special Fund for Disability Benefits (if otherwise eligible).


How are benefits calculated?

New York State sets the maximum benefit for statutory policies at $170/week. Statutory benefits are calculated as follows:

  • Your employees receive 50% of their average weekly wage (based on their last 8 weeks of employment, not counting the week in which the disability began – if its inclusion would lower their benefit rate) to a maximum benefit of $170 a week.
  • Benefits are payable for a maximum of 26 weeks of disability (during a period of 52 weeks or during any one period of disability).
  • The first 7 days of disability constitute a waiting period for which no benefits are paid. Benefits begin on the 8th day of consecutive disability.
  • Benefits are pro-rated based on the number of days you report as the days they work.

If you offer enhanced benefits, your employees receive benefits based on your disability benefits plan.


How do my employees apply for DBL benefits?

If their disability begins while they are employed (or within 4 weeks of termination), they should file a completed DB-450 Statement with your DBL carrier within 30 days.

  • Give them Form DB-450 (Notice of and Proof of Claim for Disability Benefits). They can also request the form from your DBL carrier or the Workers' Compensation Board.
  • Provide them with the Statement of Rights (Form DB-271S).
  • Have them complete and sign Part A (Claimant's Statement).
  • The attending health care provider must certify that your employee’s disability or illness prevents them from working by completing and signing Part B (Health Care Provider's Statement).
  • Fill out Part C (Employer’s Statement).
What about former employees who are now unemployed?

They may still file for DBL benefits. If their disability occurs within 4 weeks after their employment is terminated, benefits are paid by your insurance carrier. If they become disabled in the period between 4 and 26 weeks after termination, they receive benefits from the Special Fund for Disability Benefits, which is administered by the Workers' Compensation Board.

How do they apply for benefits after 4 weeks of termination?

They will need to file completed claim Form DB-300 with the Workers' Compensation Board directly:
Workers' Compensation Board
Special Fund for Disability Benefits
Disability Benefits Bureau
100 Broadway (Menands)
Albany, NY 12241

My employee missed the 30-day deadline to file the claim. What happens now?

In accordance with New York State DBL regulations, if a claim is filed late, benefits will be denied for any period of disability prior to 2 weeks before it was filed unless your employee can demonstrate that it was impossible to file sooner. And if the claim is filed later than 26 weeks after the disability began, your employee will be denied benefits. (Exception: Minors, mentally or physically incompetent people with no guardian may have a longer period in which to file a claim.)


How to submit a claim

Send your completed claim form with documentation to First Rehab Life via
E-mail: claimforms@firstrehab.com
Fax: 516-504-6414
Mail: DBL Claims • First Rehab Life • 600 Northern Blvd. Great Neck • NY11021