Learn About The Quirks Of Filing A Social Security Disability Claim And Appealing A Denial In New York
By Lorraine Netter, Contributing Author
While Social Security disability insurance and Supplemental Security Income are administered by the federal government according to federal law, in New York State, there are a few differences in the approval rates and in the amounts of the SSI monthly payment. Whether you’ve filed a disability claim in New York or you’re about to file a claim with Social Security and you live in New York, here are some things you should know.
Social Security Disability Attorneys In New York Who Take A Stand For The Injured And Disabled
New Yorkers are known for being hard workers with a strong sense of independence and self-sufficiency. So when an injury or illness has them laid up or out of work for a time, they often don’t realize they can receive benefit payments from the Social Security Administration to help them make ends meet. Social Security isn’t only a retirement program it’s a disability program as well. You paid taxes on your earnings while you were working and you have the right to collect disability benefits from Social Security if you can’t work. If you are suffering from car accident injuries, a serious illness such as cancer, a workplace back injury or anything that keeps you from working, you may be eligible for SSD benefits, which can help you recover and get back on your feet.
How Much Do I Have To Pay For Employer Disability Benefits
Mandatory Disability Insurance rates vary from each New York State authorized insurance carrier, so it is best to shop around. Rates are charged per each covered male and female employee. Premiums can be paid annually in advance or quarterly in arrears.
Employers may collect a salary deduction from employees to help fund their insurance obligation. The employee contribution rate is 0.5% of the first $120.00 of weekly wage and not to exceed $.60 per week or $31.20 per year. The employer funds the remainder of plan cost. Employers do not have to require employee contributions. New York is among one of the few states that requires employer disability benefits. Other states that require disability benefits are: California, Hawaii, New Jersey, Rhode Island and Puerto Rico.
For more information or if you would like a custom quote for your business, please call: 800-514-3513
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How Do You Apply For Disability In Ny
There are two ways to apply for disability benefits in New York. You can either apply online at or you can apply in person at a local Social Security office. Schedule an appointment by calling 1-800-772-1213 between 7:00 AM and 7:00 PM Monday through Friday or show up at the office without an appointment. To apply for disability online, you have to meet the conditions listed below:
â The applicant must be 18 years of age or older.
â The applicant must not be able to work due to an unexpected medical condition that will likely last for at least 12 months or result in death.
â The applicant must not be currently receiving benefits through their own Social Security record.
â The applicant must not have been denied benefits for a disability within the preceding 60 days.
If the application was denied recently, there is an Internet Appeal application that the applicant can use to request a review of the denial determination that was made.
Once an applicant has applied for disability, they can then apply for Supplemental Security Income online if certain requirements are met. An applicant is eligible to file for SSI if they meet the following requirements:
â The applicant must be between the ages of 18 and 65 years.
â The applicant should not have ever been married.
â The applicant must not be blind.
What Conditions Are Considered For Disability
To qualify for Social Security Disability Insurance, an applicant must have a medical condition that is expected to last for at least one year or longer. The disability may, in some cases, be life-threatening. Many of the conditions that would qualify the applicant for disability are listed in the Social Security disability blue book. Conditions in the listing manual for 2020 include:
â Back injuries and musculoskeletal conditions
â Heart failure, coronary artery disease and other cardiovascular conditions
â COPD, asthma, or other respiratory illnesses
â Sensory or speech issues including blindness or hearing loss
â IBD or liver disease and other digestive tract problems.
â Multiple Sclerosis, cerebral palsy, Parkinsonâs Disease, Epilepsy or other neurological disorders.
â Sjogrenâs Syndrome or Marfan Syndrome and other various syndromes.
â Depression, anxiety, autism, intellectual disorders, or other mental disorders.
â Dermatitis and other skin disorders.
â HIV/AIDs, lupus, rheumatoid arthritis and other immune system disorders.
â Genitourinary problems including kidney disease.
â Hemolytic anemias, disorders of bone marrow failure and other hematological disorders
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Ny State Insurance Fund
Policies may also be purchased through NYSIF, a public insurance carrier. NYSIF is a not-for-profit agency of the State of New York that offers workers’ compensation, New York State disability benefits and Paid Family Leave insurance. It is a separate and distinct entity from the New York State Workers’ Compensation Board.
NYSIF must provide insurance to any employer seeking coverage, regardless of the employer’s type of business, safety record or size. However, if an employer owes NYSIF money from a previous bill or account, coverage can be denied.
Filing A Claim For Nys Disability Benefits
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 his/her insurance carrier, using form DB-450. This form is available on-line or you may obtain a copy for the nearest Workers Compensation Board district office. Keep a copy of this form to submit again if your claim is not paid properly.
If you have been unemployed for more than four weeks from the date the disability began, file the claim with the Disability Benefits Bureau, using form DB-300.
You must file your claim within 30 days after you become disabled. If you file late, you will not be paid for any disability period more than two weeks before the claim is filed.
You must be under the care of a physician, chiropractor, podiatrist, psychologist, dentist or certified nurse midwife in order to qualify for benefits. Your health care provider must complete and sign the Health Care Providers Statement as proof of your disability.
Before filing your workers comp claim, be sure that you have completed and signed the Claimants Statement and your health care provider or practitioner has completed and signed his/her portion. Submit this information promptly to avoid delaying your claim.
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How Long Does It Take To Get Approved For Disability In Ny
As a general rule, it takes between 30 days and six months to get approved for disability in New York, but there are edge cases where the approval is granted prior to 30 days and of course, there are times when the decision takes longer than 6 months. Many experts recommend that applicants prepare to wait between 3 to 5 months from the time of application to receive an initial decision about SSDI benefits. Appeals cases get backlogged and in 2017, for example, there were more than one million cases waiting to be reconsidered. Applicants wait an average of 18 months to receive either approval or denial of benefits after an appeal.
If you are a Medicaid recipient and you are approved for disability, you can qualify for a caregiver to help with your day to day activities.
New York State Disability Insurance Taxes
Employers in New York are required by law to provide SDI coverage for eligible employees to cover Off-the-Job Injury or Illness. Employers can choose to cover the entire cost or withhold $ 0 .60/ week of eligible employees’ wages to share the cost of coverage.
Example: $ 0 .60/ week x 52 weeks = $31. 20
Monthly: $31. 20 /12 = $ 2 .60
Biweekly: $31. 20 /26= $ 1 .20
Semi Monthly: $31.20/ 24 = $ 1 .30
Employers who use Zenefits Payroll can choose to withhold 0.5% of eligible employees wages in each payroll for NY SDI. However, Zenefits Payroll will only withhold, but not pay or file NY state disability taxes for employers. Employers are responsible for remitting these taxes to their NY SDI carrier. Learn more.
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New York Disability Health Resources
Medical records are an important piece of the puzzle when youre applying for disability benefits in New York. Youll need to have medical records that reflect the symptoms and disabling conditions that prevent you from working. When you apply for disability in New York, a claims adjudicator working for New York Disability Determination Services will review your medical records and decide whether or not you are eligible for disability benefits. If your claim is denied, you can submit additional records at each stage of the appeals process.
Sometimes New York disability applicants may find it hard to obtain the necessary medical treatment. Luckily, you may be able to obtain free of reduced-cost healthcare. Some options are listed below.
Access Community Health Center
How To Apply For Disability In New York
If you live in the state of New York and are unable to work due to a severe illness or injury, you may be eligible for disability benefits. If you believe you fall into this category, follow the guidelines below to begin the application process.
Determine Your Eligibility
To be eligible for disability benefits, you must have a medical condition that makes it impossible for you to do the work you did before your illness or injury. You must also have paid into Social Security through a previous employer and earned enough work credits. In most cases, you need 40 work credits, half of which were earned within the past 10 years, to receive this benefit.
To complete your application, provide documentation of your situation along with your application forms through the Social Security Administration . Have the following documents on hand before you begin the application process:Social Security numberContact information for medical professionals, clinics and hospitals involved in your medical careList of medications you have taken or are taking as well as the prescribed dosesList of workplaces and types of work completedProof of birthLab tests and resultsMost recent W-2 form or federal tax returnIf your family members qualify for benefits as dependents, the names, Social Security numbers, and birth certificates of all applicantsTo include your spouse on the application, proof of marriage. Also, the dates of any previous marriages.
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Faq: Where Does Ssdi Funding Come From
Monthly SSDI benefits in NY are funded by payroll taxes through the United States Social Security Program. This is the same federal program that pays monthly benefits to a large number of retired Americans, including New York residents. The federally-managed Social Security Disability law sets the eligibility requirements for NY SSDI.
How Much Does Disability Pay In Ny
For an individual, the federal monthly benefit amount is $771. For a couple, the benefit amount is $1,157 per month. The actual amount that a beneficiary receives, however, depends on the income they received prior to leaving their job and the amount of taxes they paid during the time they were working.
Beneficiaries canât collect disability benefits at the same time that they receive paid family leave benefits. A beneficiary may only collect benefits for 26 or fewer weeks from either disability leave or paid family leave during any 52 week time period.
While on disability in New York, beneficiaries are responsible for their medical care expenses. Neither the employer nor their insurance carrier is responsible for any medical expenses the beneficiary incurs.
Prior to receiving disability, the beneficiaryâs employer is allowed to take a contribution from employees to offset their disability insurance benefits costs, but this isnât required. The contribution that an employer can take is 0.5 percent of the employees wages, but no more than 60 cents per week. Employees with two jobs that yield more than $120 per week can ask for an adjustment in the contribution from two employers such that the combined contributions donât exceed 60 cents weekly.
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Enhanced Disability And Paid Family Leave Benefits
An employer may choose to provide enhanced benefits such as increased monetary pay out, a shorter waiting period duration to collect benefits, or a longer duration for benefits to be paid. These benefits must be secured through a carrier licensed to write New York State statutory disability and paid family leave coverage or through Board approved self-insurance. These enhanced benefits are filed with the Board by the carrier or self-insured.
Medical Record Fees Limit In New York
With regards to obtaining medical records to submit with your disability application, New York allows doctors and other medical professionals to charge a reasonable fee for medical records. However, the charge may not exceed 75Â¢ per page. Additionally, your doctor cannot deny you your medical records because you are unable to pay for them.
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Disability And Paid Family Leave Benefit Plans
Employers may provide New York State Disability and Paid Family Leave benefits to their eligible employees under a Board approved Plan. All Plans must be accepted by the Board and will need to adhere to the statutory requirements of the New York State Disability and Paid Family Leave Law . Once a Plan has been accepted by the Board, the employer must provide administration of these benefits from a licensed NYS insurance carrier, or by obtaining the Boards approval to administer benefits as a Self-Insured employer.
Social Security Disability: How To Secure Benefits After A Serious Injury
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In New York, people who suffer injuries in automotive accidents can file claims for insurance reimbursement regardless of who caused the collision. Additionally, some may also qualify for Social Security Disability . The process of getting those benefits can often be complex and confusing. The information below will help guide you through the process.
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New York State Disability
Disability benefits are temporary cash benefits paid to an eligible wage earner, when he/she is disabled by an OFF THE JOB injury or illness. The Disability Benefits Law provides weekly cash benefits to replace, in part, wages lost due to injuries or illnesses that do not arise out of or in the course of employment. Although New York State Disability is generally for off-the job injury or illness, there are exceptions:
If you have received a written rejection of your Workers Compensation claim , and you have been disabled from working for more than five days, you may apply for New York State Disability Benefits and you may continue to pursue your Workers Compensation claim at the same time. Disability benefits are also paid to an unemployed worker to replace unemployment insurance benefits lost because of illness or injury.
This temporary disability benefits system is administered by the NYS Workers Compensation Board, and most plans are jointly financed by you and your employer. An employer is allowed to collect contributions from its employees to offset the cost of providing benefits. Disability covers almost the same workers as the Workers Compensation system. To qualify for the disability benefit, you must have worked at least 30 days.
Differences between NYS Disability Benefits and Workers Compensation:
Provide Medical Evidence Of Your Disability
When completing your disability application in NY, you need to include medical evidence of your medical condition and disability status. The New York Disability Determination Services will complete an in-depth evaluation of your medical condition and disability. If there is insufficient evidence in your application to verify the severity of your medical condition, the NYDDS will arrange a consultative examination of your condition.
If you are unsure whether or not your condition qualifies for SSDI, call 855-468-7626 for a free consultation with a New York Social Security Disability Lawyer.
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Additional Resources On Disability Claims In Ny State:
Can You Go On Disability For Depression
It is possible to go on disability for depression, but an individual with this disorder must meet certain criteria to be eligible to receive benefits. The specific criteria are listed in Social Securityâs listing manual. In some cases, applicants may be granted disability on the basis of a medical-vocational allowance if the depressive symptoms are severe and other factors are present in the applicantâs work history, age, and level of education.
Depression is listed as Social Securityâs impairment listing 12.04, Depressive, Bipolar, and Related. To qualify for Social Security disability benefits for depression, you must demonstrate that you have a severe form of the disease by manifesting at least five of the following symptoms:
â Depressed mood
â Diminished interest in all or almost all activities
â Poor appetite or overeating that results in a demonstrable change in weight
â Sleep disturbances
â Inability to concentrate or think clearly
â Feelings of guilt or worthlessness
â Thoughts of suicide or death
â Slow physical movement or reaction time
â Slowed speech and physical agitation such as hand wringing or pacing
Additionally, you must meet certain functional criteria that show that your ability to work has been impaired as a result of the depressive disorder. An extreme or âmarkedâ limitation in two of the following areas is necessary to receive disability benefits for depression:
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