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A GUIDE TO DISABILITY BENEFITS

www.wcb.ny.gov

Benefits Law (form DB-271), within five days of learning that the worker is disabled. How to File a Claim If you are currently employed, or if you have been unemployed for less than four weeks from the date the disability began, file the claim with your employer or insurance carrier, using form DB-450. There is a …

  Db 450

STATEMENT OF RIGHTS NEW YORK STATE DISABILITY BENEFITS

www.wcb.ny.gov

3. TO CLAIM BENEFITS you should file written notice and proof of disability (Claim Form DB-450) with your employer or the insurance carrier named below within 30 days from the first day of your disability, or all or part of your claim may be rejected. In no event should …

  Db 450

New York State NOTICE AND PROOF OF CLAIM FOR …

www.wcb.ny.gov

Workers' Compensation Board, Disability Benefits Bureau, PO Box 9029, Endicott, NY 13761-9029. If you answered "Yes" to question 13.B.3, please complete and attach Form DB-450.1. If you do not receive a response within 45 days or if you have questions about your disability benefits claim, please call your employer's insurance carrier.

  Benefits, Db 450

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