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  • Ny Db-136 2019

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EMPLOYER'S APPLICATION FOR VOLUNTARY COVERAGE for Class of Employees for Whom Disability and Paid Family Leave Benefits are Not Required by Law (Employee Contribution Required) NYS Workers' Compensation.

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New York is one of a handful of states that require employers to provide disability benefits coverage to employees for an off-the-job injury or illness.

You can waive coverage of Paid Family Leave if: You regularly work 20 hours or more per week, but you won't be in employment with that employer for 26 consecutive weeks; or. You regularly work fewer than 20 hours per week and you will not work 175 days in a 52-week period.

After a seven-calendar-day waiting period or the exhaustion of your sick leave accruals (whichever is greater), you receive 50 percent of your average salary for the eight weeks before disability, up to the maximum benefit established under the New York State Disability Benefits Law, currently $170 per week.

Employees with an injury or illness not related to their job may be eligible for short-term disability benefits. Paid Family Leave does not replace disability benefits coverage. After giving birth, a worker may be eligible for both short-term disability benefits and Paid Family Leave.

The current maximum amount for SSDI payments is $3,345 per month. For SSI payments, by contrast, the maximum monthly amount a disabled individual can receive in 2023 is $914 for an eligible individual, and $1371 for an eligible individual with an eligible spouse.

Employees with a regular work schedule of 20 or more hours per week are eligible after 26 consecutive weeks of employment preceding the first full day of leave. Employees with a regular work schedule of fewer than 20 hours per week are eligible after 175 days worked preceding the first full day of leave.

NY Paid Family Leave Voluntary Coverage: What to consider Type of BusinessRequired to have DBL?Public Employer (Town, Village, City, State, Fire District, Water District, Public Library*, Municipality, Public Authority)NoSole Proprietor without employeesNoPartnership without employeesNoChurch, SynagogueYes6 more rows

The employee is ineligible for disability benefits if they perform any type of work for which wages or profit were received, even if performed at home. If an employee is unemployed, disability benefits may also be paid to replace unemployment insurance benefits lost because of illness or injury (WCL §207).

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232