New York Short-Term Disability and Pregnancy
New York is one of the few states that has a temporary disability insurance program, which requires employers to provide short-term disability insurance for their employees. Employers are required to provide partial wage replacement, for up to 26 weeks, to employees who are temporarily unable to work due to disability. Pregnancy and childbirth are covered under the law.
In 2018, New York will start phasing in its new paid family leave program, which will provide up to 12 weeks of paid benefits to employees who need time off to care for a new child (among other reasons).
Which Employers Must Provide Insurance?
New York law requires employers to provide coverage, either by purchasing insurance (from a private carrier or the state) or by self-insuring. These employers must provide coverage:
- An employer that has had at least one employee in each of 30 days in a calendar year. (The 30 days need not be consecutive.) Once the employer hits the 30-day mark, the employer must provide coverage four weeks later.
- Those who employ domestic or personal employees (including in a private home), if those employees work at least 40 hours a week for the same employer.
- An employer that is a successor to a covered employer. These employers must immediately provide benefits.
An employer may also elect to provide coverage, even if it isn't legally required to, by filing an Application for Voluntary Coverage.
Employers may collect a small amount from employees to help fund their insurance obligation; however, this amount may not exceed 60 cents per week. Employers don't have to require employee contributions.
Which Employees Are Covered?
An employee is entitled to coverage if he or she suffers an off-the-job illness, injury, or other disabling event (including pregnancy) and:
- the employee has worked for a covered employer for at least four weeks
- the employee works for a successor of a covered employer
- the employee is a domestic or personal employee who works at least 40 hours per week for one employer, or
- the employee works for an employer who has voluntarily elected to provide coverage.
Coverage for Pregnancy Disability
Pregnancy and any related illness or complication is one of the medical conditions covered under New York’s temporary disability insurance. An employee is entitled to coverage only for the time when she is actually unable to work due to pregnancy or childbirth. An employee who becomes disabled more than four to six weeks prior to giving birth or continues to be unable to work more than four to six weeks after giving birth may have to submit additional medical documentation to support her claim. The maximum period of disability under the law is 26 weeks.
An eligible employee may collect up to 50% of her average weekly wages prior to going out on disability, up to a cap (currently, $170 per week). Benefits aren't payable for the first seven days.
Filing a Claim
To file a claim for short-term disability coverage, you must file a claim (Form DB-450), available from your employer or the insurance carrier. You must file this form within 30 days of your disability. If the insurance carrier or your employer (if it is self-insured) decides that your claim is not covered, it is required to notify you within 45 days. If this happens, you have the right to a review by the New York Workers' Compensation Board (which oversees the state's short-term disability program).
Help From an Attorney
If you have been discriminated against because of your pregnancy, or your claim for benefits is unfairly denied, you may with to consult with an experienced disability employment attorney.