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Obtain a Notice and Proof of Claim for Disability Benefits (Form DB-450), either from the Board at wcb.ny. The DB450 Claim Form is the initial form used to file a disability benefits claim for individuals who become disabled due.Your employer must fill out Part C (Employer's Statement). What if my disability begins more than four weeks after termination? You must complete all items of part A – The "CLAIMANT'S STATEMENT". The "Statement of Rights" indicates that a claim form must be filed within 30 days (but not more than 26 weeks) from the date the disability begins. The New York State Disability Benefits application consists of the DB-450 form. The New York State Disability Benefits application consists of the DB-450 form. This summary is not a complete statement of the rights, benefits, limitations or exclusions of the insurance described here. Documents on this website are PDFs.