New York Disability
Benefit Law (NY DBL) and
Paid Family Leave (NY PFL)
New York Disability Benefit Law (DBL) provides short-term disability benefits and Paid Family Leave (PFL) provides wage replacement benefits to eligible employees who need time off from work for qualifying reasons. Employees may be eligible for DBL if they are unable to work due to a non-work-related injury or illness, including during pregnancy and/or childbirth. Employees may be eligible for PFL to bond with a new child, care for a sick family member, which could include organ donation, and address a qualifying military exigency.
MetLife provides fully insured and self-insured coverage options. In most cases, NY PFL is a rider on the fully insured NY DBL policies.
Benefit Overview
Mandated Coverage & Employee Eligibility
HintLeave Reason, Duration, Job Protection
HintCost of Coverage and Contributions
HintBenefit Payments
HintEmployers are required to offer NY DBL and PFL if they have at least one employee working in New York State on each of at least 30 days in any calendar year. The state provides additional coverage details.
Almost all employees working in New York for a covered employer are eligible for benefits.
For NY DBL, full-time employees are eligible after 4 weeks of consecutive employment. Part-time employees are eligible after their 25th day of employment.
For NY PFL, employees who work 20+ hours per week are eligible after working 26 consecutive weeks. Employees who work less than 20 hours per week are eligible after completing 175 days of work.
NY PFL is mainly for people who work in New York. Usually, where an employee lives doesn’t matter when deciding if their job counts as New York employment. If an employee works in New York, their job is considered New York employment. If an employee only works in New York part of the time, whether they’re covered depends on other factors. Employees who do not meet the eligibility criteria can sign a waiver to opt out of benefits and not pay contributions. However, if their schedule changes and they become eligible later, they will be responsible for paying retroactive contributions.
Self-employed individuals or business owners have special eligibility rules that apply. Click here for more details.
While NY DBL does not provide job protection, NY PFL does. Job protection may also be provided through other federal or state laws such as the federal Family and Medical Leave Act (FMLA).
An employee can have more than one benefit each year, but no more than 26 weeks combined PFL and DBL in a 52-week period.
Disability Leave can be taken for up to 26 weeks, after a 7-day waiting period, to:
- address a personal serious health condition, including pregnancy and/or childbirth
DBL benefits are available 4 weeks before an employee’s due date and 6-8 weeks after giving birth.
Family Leave can be taken for up to 12 weeks to:
- bond with a new child
- take care of a family member with a serious health condition
- assist while loved ones are on overseas military deployment
NY PFL can only be taken in full day increments.
Beginning January 1, 2025:
- NY DBL: The maximum employee contribution is 0.5% up to a cap of $0.60 weekly, which matches the state’s employee contribution requirement. MetLife plans are individually underwritten, and employers fund the balance of the cost if there is any.
- NY PFL: For 2025, MetLife’s premium rate is based on the state mandated community rate of 0.388% with a maximum contribution of $354.53 per employee per year. This community rate is set by the state of New York and all insurance carriers charge the same rate. NY PFL is fully funded by employee contributions, but employers can choose to fund it on behalf of their employees. In addition, employee PFL contributions must be deducted on an after-tax basis. Pre-tax contributions are not allowed.
Please visit the state program’s website or the latest state rates and additional state plan information.
The benefit amount an employee may receive is based on their average weekly pay and New York’s current maximum weekly benefit. Benefits are locked in based on the first day of absence.
NY DBL benefits are paid as a percentage of an employee’s average weekly wage. Employees may receive 50% of their average weekly wage up to the maximum, or $170.0-0 per week.
NY PFL benefits are paid as a percentage of an employee’s average weekly wage. Employees may receive 67% of their average weekly wage up to the maximum of $1,177.32 per week, which is 67% of the state average weekly wage.
In 2025, the state average weekly wage is $1,757.19.
Key Dates
- State average weekly wage of $1,757.19 is effective
- Maximum PFL benefit becomes $1,177.32
- Maximum DBL benefit remains the same at $170
Applying for a MetLife Private Plan & Employer Requirements
To obtain a quote from MetLife, you or your broker must create a census of your eligible New York workforce and send it to MetLife.
MetLife offers a few coverage options:
- A Fully Insured NY DBL policy with NY PFL rider
- A fully insured NY PFL policy if you have a self-insured NY DBL plan
- Self-insured NY DBL/PFL administration
If fully insured, MetLife will issue a state approved NY DBL policy with a PFL rider.
If self-insured, MetLife will issue an Administrative Services Agreement.
If fully insured, MetLife will file the coverage with the state on your behalf.
If self-insured, you will need to file your plan with the state.
You are required to post an employee notice in a location that is easily seen by all employees working in New York. The notice must also be provided each year, to new hires, and when learning an employee is experiencing an event that triggers eligibility.
If you have a fully insured MetLife plan, you will receive a notice to use with employees.
If you have a self-insured plan, you may obtain this notice by contacting the NYS Workers’ Compensation Board at certificates@wcb.ny.gov.
Reporting requirements:
For fully insured plans, MetLife will submit quarterly reports to the state on your behalf.
For self-insured plans, you are responsible for completing and submitting the DB-681 (DBL and PFL included) annual report to the state. MetLife will provide you claim information to assist with completing Tables 1 and 2.
Taking a Leave
Filing for Benefits with MetLife
HintSupporting Claim Documentation
HintCoordination of Benefits
HintStep 1: An employee should notify their employer of the need for a leave as soon as possible.
Step 2: An employee should file a claim up to 30 days in advance of the leave. If the leave is unforeseeable, claims may be submitted up to 30 days after the leave has begun.
Step 3: MetLife will gather any additional necessary information from the employee and make a decision within 18 calendar days or the first day of leave, whichever is later.
Step 4: The employee will receive their first benefit payment within two weeks of claim approval.
Step 5: If an employee’s claim is denied, an employee may appeal the claim first with MetLife and if denied again the employee may submit an appeal to the state.
Employees must provide specific documents for each claim. It is important to submit paperwork to the doctor as soon as possible. It might take the doctor’s office two weeks or more to complete the paperwork. In some cases, a statement confirming the relationship between the employee and the family member may also be requested.
For the employee's own disability (when the employee is sick or hurt and cannot work for an extended period):
- Certification of a Disability/Serious Health Condition form filled out by the employee and their healthcare provider, or
- A doctor’s note or Attending Physician Statement (APS) that includes the same information as the Certification form
For child bonding for a newborn:
- A copy of the child’s birth certificate, or
- A statement from the child’s healthcare provider stating the child’s date of birth, or
- A statement from the parent’s healthcare provider stating the child’s date of birth
For child bonding for adoption or foster care placement:
- A copy of adoption papers or court documents finalizing the adoption that includes child's date of birth and adoption date, or
- Documentation from the child’s healthcare provider, or
- Foster/adoption agency paperwork containing adoption or placement
- If the employee is not the parent named in the court documents (in loco parentis), the employee may also be asked to provide proof verifying their relationship to the in loco parentis named in the court documentation. This could be a marriage certificate, civil union papers, or something showing you are in a domestic partnership.
For leave to care for a family member with a serious health condition, including medical events related to pregnancy or childbirth:
- Certification of a Disability/Serious Health Condition form filled out by the employee and their family member’s healthcare provider, or
- A doctor’s note or APS that includes the same information as the Certification of Serious Health Condition form
For qualifying military exigency needs, the employee will need to verify their family member’s service:
- Covered family member’s active-duty orders, or
- Letter from the military unit documenting impending call or order to covered duty, or
- Documentation of military leave signed by the approval authority for the military member’s Rest and Recuperation
- If leave is requested to meet with a third party, such as a school official, counselor, or attorney, the employee must provide documentation of the meeting that includes:
- The name, address, and contact information of the individual or entity with whom the employee is meeting
- A description of the meeting
Employees may be eligible for more than one leave.
MetLife’s claims team will reach out to the employee to coordinate dates of the company leave that directly overlap with the state leave.
An employer cannot require an employee to take other accrued benefits or company provided leave before PFL. If the employer offers, the employee can choose to use other leave to top off their PFL to receive 100% of their average weekly wage.
In general, DBL and PFL cannot be taken at the same time. DBL or PFL and federal FMLA benefits can and should be used at the same time when applicable. Sick pay and PFL or DBL benefits may be received simultaneously, though benefits may be reduced by other income benefits received.
Starting on January 1, 2025, employees in New York who are pregnant may also have additional paid time off available to them for doctors’ appointments, procedures, or other types of prenatal care. This paid prenatal personal leave is part of New York’s paid sick leave program, which is separate from New York State Paid Family Leave.
MetLife representatives can help review employer paid benefits that may overlap with the state leave. They can help document overlaps and preferred contact and action when the overlap happens.
Note: There may be additional leaves that MetLife does not administer. Employers may be responsible for providing additional leaves for their employees. Employers should consult their own employment attorneys.
Need more information?
FAQs
A child, parent, parent-in-law, spouse, grandchild, grandparent, sibling, or domestic partner (registration not required).
As of November 20, 2024