(Off-the-Job Injury or Illness)
Complying with the Disability Benefits Law
An employer who has had in New York State employment one or more employees on each of at least 30 days in any calendar year shall be a "covered employer" subject to the Disability Benefits Law after the expiration of four weeks following the 30th day of such employment (WCL §202). These 30 days of employment need not be consecutive days but must be work days of employment in one calendar year. In addition to the above-stated provisions, employers of personal or domestic employees in a private home are subject if they employ at least one employee who works 40 or more hours per week for that one employer.
An employer who by operation of law becomes successor to a covered employer, or who acquires by purchase or otherwise the trade or business of a covered employer, immediately becomes a covered employer.
A "covered employer" under the law is required to provide for the payment of Disability Benefits to all eligible employees, which includes full-time and part-time employees. The employer may comply by purchasing a policy of insurance or by applying to the Chair for approval as a self-insurer with permission to deposit securities or file a surety bond. Insurance may be purchased from any insurance company authorized to write Disability Benefits insurance in this state, including the State Insurance Fund.
All information pertaining to premium rates, filing of forms or other data in connection with the policy will be supplied by the carrier of the employer's choice. Accordingly, employers are not required to send any forms to the Workers' Compensation Board nor make any premium payments to the Board. Premiums for Disability Benefits insurance policies are paid directly to the insurance carrier by the employer.
A covered employer is authorized to collect from each employee, through payroll deduction, a contribution of 1/2 of 1% of wages paid, but not in excess of 60 cents per week. However, an employer may waive all employee contributions or, by employee agreement and acceptable to the Chair, arrange for employee contributions in excess of the statutory rate if the amount is reasonably related to the value of the benefits provided. Every covered employer bears the cost of providing benefits in excess of the contributions collected from employees (WCL §§209, 210).
Each covered employer must post and maintain conspicuously at the place or places of business a prescribed form, Notice of Compliance, Form DB-120, stating the provisions have been made for the payment of disability benefits to all eligible employees. Also, whenever an employee of a covered employer is absent from work due to disability for more than seven consecutive days, the employer shall, within five days thereafter, provide the employee with prescribed Form DB-271S), Statement of Rights under the Disability Benefits Law. Both forms may be obtained from your insurance carrier.
Religious, charitable or educational institutions operating on a non-profit basis are required to obtain disability benefits insurance or to provide disability benefits through approved self-insurance to all of their employees, with exceptions, as noted below, if they employ one or more employees.
The following classes of employees are excluded from mandatory coverage: a duly ordained, commissioned or licensed minister, priest or rabbi; a sexton; a christian science reader; a member of a religious order (12 NYCRR §355.2).
Also excluded from mandatory coverage are persons engaged in a professional or teaching capacity in or for a "religious, charitable or educational institution"; or an executive officer of an incorporated religious, charitable or educational institution; or persons participating in or receiving rehabilitative services in a sheltered workshop operated by such institutions under a certificate issued by the U.S. Department of Labor; or volunteers in or for such institutions; or recipients of charitable aid from a religious or charitable institution who perform work in or for such institution which is incidental to or in return for the aid conferred, and not under an expressed contract of hire (12 NYCRR §355.2).
The term "religious, charitable or educational institution" means a corporation, unincorporated association, community chest, fund or foundation organized and operated exclusively for religious, charitable or educational purposes, no part of the net earnings of which inure to the benefit of any private shareholder or individual.
Many organizations have sick leave plans, salary continuance arrangements or other disability plans on a voluntary basis or as a result of collective bargaining (WCL §211). Although some of these plans may comply with the Disability Benefits Law, if secured by disability benefits insurance or approved self-insurance, most do not. When employers make inquiries to qualify their plans, Board staff will suggest modifications to make such plans "at least as favorable" as the benefits required by the Disability Benefits Law and therefore, acceptable to the Chair. The Board welcomes all such inquiries.
An employer may provide benefits under a Board-approved Plan for Disability Benefits or one negotiated by agreement and accepted by the Chair of the Board as meeting the requirements of the New York State Disability Benefits Law (DBL) only when the plan is insured through a carrier licensed by New York State to write statutory disability benefits insurance policies, or by an employer authorized by the New York State Workers' Compensation Board to self-insure for disability benefits.
Questions in connection with the acceptability of disability benefit plans or with respect to employer compliance with the Disability Benefits Law should be directed to the Disability Benefits Coverage Section, 100 Broadway-Menands, Albany, NY 12241.