Important: We updated this article in October 2023 to make sure all info below is both current and correct. If you become disabled in New York state, you have several options to get cash benefit payments while you heal or recover. Filing a claim with the state’s New York disability program is always your first course of action. Read on to learn how the New York state law works and how it can provide disability benefits coverage to you and your family. Then, we’ll review two federal programs that can pay long-term cash benefits for permanent health issues.
How Does New York State’s Short-Term Disability Benefits Program for an Off the Job Injury or Illness Work?
New York is 1 of 5 states where employers must provide disability benefits coverage for an off the job injury or illness. The Disability and Paid Family Leave Benefits law in New York state provides those short term disability benefits to eligible employees. The state’s disability benefits law should partially replace any wages lost due to an off the job injury or illness.
Timing: You Must File Within 30 Days After Becoming Disabled
File with your employer or insurance carrier using Notice and Proof of Claim for Disability Benefits (Form DB-450).
Determining Your Eligibility for Short Term Disability Cash Benefits in New York
If your disability starts while you qualify for or are collecting unemployment benefits and it makes you ineligible to draw those payments, then you qualify for New York state disability.
New York State Medical Evidence Requirements
One of the following medical care providers must treat you regularly to get short-term disability in New York state:
- Physician
- Chiropractor
- Podiatrist
- Psychologist
- Dentist
- Certified nurse midwife
How Much Are Weekly Cash Benefits in New York State?
New York state disability benefits are cash-only and equal 50% of your average weekly wage for the last eight weeks. However, the maximum payment is $170 per week.
New York employers or their insurers pay short-term disability benefits after a required 7-day unpaid waiting period. Under state law, insurers cannot provide disability benefits until the eighth consecutive day off work.
In addition, New York state cash benefits are:
- Subject to Social Security and Medicare taxes.
- Paid for a maximum of 26 weeks during any 52-week period.
- Not available to independent contractors because legally, they aren’t employees.
You cannot collect both disability benefits and Paid Family Leave (PFL) at the same time. The total combined short-term disability and Paid Family Leave in any 52-week period cannot exceed 26 weeks. Pregnant applicants can collect short-term disability benefits for 4 weeks before your due date. Then, you can collect for another 6 weeks after giving birth. If you deliver by Caesarian section, you can collect for 8 weeks. You may be eligible for the maximum 26 weeks of payments with documentation from your family doctor.
What Federal Programs Are Available to New York Disability Applicants?
Two federal benefit programs, SSI and SSDI, may provide disability benefits coverage for a long-term injury or illness. Let’s review some FAQs about these two programs:
How Federal Social Security Disability Insurance (SSDI) Benefits Work
The Social Security Administration (SSA) manages a federal disability insurance benefits program you can turn to. However, SSDI doesn’t cover temporary disabilities lasting less than a year. Keep reading to learn whether you may be eligible for New York disability benefits from the SSDI program.
Which New York Disability Applicants May Be Eligible for SSDI Benefits?
It’s important to understand that everyone who works isn’t automatically covered under the federal SSDI program. You likely have federal disability insurance coverage if:
- You worked five in the last 10 years at a job where you paid FICA payroll taxes. Some people not eligible for SSDI include service-industry workers (bartenders, waitstaff); union members (teachers, firefighters) and federal or state employees. In addition, if you stopped working more than five years ago, you also won’t qualify for SSDI. That’s because once you stop paying premiums for 60 continuous months, your disability benefits coverage automatically lapses.
- Your doctor says your condition will last for at least one year or result in your death. If your condition improves enough for you to start working again in less than 12 months, your claim will be denied.
- You are at least 18 years old, but younger than 67. If you’re too young and haven’t earned enough work credits, you might not have coverage. Also, if you’re already at or past full retirement age, then you’re no longer eligible for SSDI. This is because SSDI converts into regular Social Security payments once you turn 67.
Time New York Disability Claimants Typically Wait for SSDI Approval
It takes the SSA approximately 3-5 months to review every SSDI claim. Federal law also has a required five-month waiting period before you can get your first SSDI payment. Therefore, we recommend applying for state New York disability benefits first.
TIP #1: The SSA approves just 1 in 5 initial SSDI claims. Further, just 35% of all people who apply for SSDI eventually get payments. This is why it’s smart to get a lawyer to help you file.
TIP #2: Make sure to have copies of your full medical records from your doctor to submit with your SSDI application. You need evidence that proves your condition stops you from working at least one year to qualify.
Social Security Disability Insurance Pay Amounts & What to Expect After Approval
The SSDI maximum benefit amount for 2023 is $3,345 per month. That said, the average monthly SSDI payment across the nation is $1,358. The SSA determines your payment amount using your highest average job wages over a 35-year period.
SSDI payments aren’t permanent. The SSA checks your disability status every 3, 5 or 7 years until you turn 67. Upon that birthday, your SSDI payment automatically turns into regular Social Security.
Finally, once you get Social Security disability insurance payments for 24 months, you’re eligible for Medicare. Medicare insurance coverage begins during the 25th month after your SSDI pay award date.
How Federal Supplemental Security Income (SSI) Benefits Work
Haven’t had a job for at least 5 out of the last 10 years or aged 65+ with very low income and few assets? Apply for SSI’s New York disability payments if you’re unable to work due to your health issues. SSI’s maximum monthly payment is $914 per person, or $1,371 per couple.
NOTE: SSI has the strictest eligibility rules of all three programs that provide disability benefits.
SSI medical eligibility requirements are the same as for SSDI. However, you must have very low income — and almost no assets — to qualify. Your total household income cannot be more than $1,470 per month. You must also own less than $2,000 in financial assets (or $3,000 for couples). There are some exceptions to the asset rule: The SSA won’t count your house, the land it sits on, one vehicle, wedding rings, and household goods, like furniture and appliances.
Once approved, you can keep your SSI payments as long as you stay under the strict income limits. Not disabled? You can also qualify for SSI after you turn 65 years old based on age alone.
When the SSA awards you SSI, you also become eligible for Medicaid insurance coverage. Medicaid coverage for York disability claimants should begin the same month as your first SSI payment.
How to Get Free Expert Help Qualifying for New York Disability
Applying for New York disability benefits can feel like too much, particularly when you don’t feel well. If you need help, talk to an experienced Social Security attorney for free over the phone.
Having a New York disability lawyer file your paperwork makes you almost three times more likely to secure benefits. All New York disability lawyers work on contingency. So, you’ll pay $0 for claim help if you don’t get paid benefits.
Already denied benefits? A New York disability lawyer can review your application and fix any mistakes.
Click the button below to start your free online benefits quiz and see if you may qualify for free expert claim help:
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Laura Schaefer is the author of The Teashop Girls, The Secret Ingredient, and Littler Women: A Modern Retelling. She is also an active co-author or ghostwriter of several nonfiction books on personal and business development. Laura currently lives in Windermere, Florida with her husband and daughter and works with clients all over the world. Visit her online at lauraschaeferwriter.com and linkedin.com.