Checklist to Get You Started
So you’re here because you yourself are under an official order of quarantine due to COVID-19 (Self-Care)? Need to care for your minor child who is under quarantine? (Go here for that information).
Follow this handy checklist to help make your claim as smooth as possible.
Your quarantine is considered a qualified quarantine – don’t file a claim unless you meet these criteria:
- Your employer has less than 100 employees (larger employers have to continue their employees salary and these DBL/PFL benefits do not apply! See the question for your benefit options if you work a larger employer in the Other FAQs section.)
- You are under an official “Order of Quarantine” issued by the by the state of New York, the department of health, local board of health, or other applicable governmental entity.
- You cannot perform your regular job responsibilities (or any alternative duties offered by your employer) due to the novel Coronavirus.
- You tested positive for COVID-19 but it was not a result of travel to a country designated by the CDC with a level 2 or 3 travel health notice. Click here for more details.
Check out this helpful infographic before you file your claim to make sure you’re eligible!
Your employer’s size further drives after how many days of quarantine you may qualify for Emergency DBL/PFL Quarantine benefits:
- Your employer has 10 or less employees with less than $1m annual net income: your entire quarantine may qualify for special DBL/PFL quarantine benefits from day 1.
- If your employer has 1-10 employees and more than $1m in annual net income or has 11-99 employees: your special DBL/PFL Quarantine benefits may begin on day 6 of your quarantine (your employer may provide paid sick leave for you during the first 5 days).
- Self-quarantine benefits are only applicable during your quarantine/isolation period (which must align with NY Dept of Health guidance). If unable to work post-quarantine due to extended recovery from Covid-19, standard disability benefits may be applied for, with form DB450.
|Type of Quarantine
||Employer Size (number of employees) 1/2020
||Employer’s Annual Income 2019
||Day of quarantine your NY Emergency DBL/PFL Quarantine Benefits kick-in*
|Self-Care lasting 14 calendar days or less.**
|| 10 or less
|| Less than $1M
| 10 or less
|| More than $1M
||Your Employer may provide Paid Sick Leave for you during the first 5 days.
||Employees at larger employers do not qualify for NY’s Emergency Quarantine Benefits. Check out the FAQ section to see what other options you may have.
**Employees who have been diagnosed with COVID-19 and are still out after 2 weeks of their employer’s sick pay, may be eligible for basic, standard DBL benefits (max benefit of $170/week of, if the employer has an enhanced DBL benefit level, at the respective coverage level of the policy in force).
You are currently considered employed.
If you have been unemployed (including furloughed, temporarily laid off, or out of work because your employer is currently closed) when your qualified quarantine began and you are collecting unemployment benefits, you cannot collect both unemployment and DBL/PFL COVID-19 benefits. Click here for more information.
Everything is completed on your COVID-19 Quarantine claim forms.
COVID-19 Quarantine Leave for Yourself
If you’re taking leave for yourself due to COVID-19 Quarantine/Isolation you must submit the following:
- DB/PFL-Self form sections 1-2, completed and signed by you
- Part A of the PFL-1 form completed and signed by you
- Section 3 of the DB/PFL form, and Part B of the PFL-1 form completed and signed by your employer.
Your employer must complete their sections and return it back to you within 3 business days.
- A mandatory or precautionary order of quarantine or isolation. See a sample here.Your claim is not complete without this official document. Read more details on how to obtain an order of quarantine here. We can’t process your claim without this official order, and if we don’t receive the order with your claim submission, your claim may be denied.
- Employer’s Questionnaire
Everything is clearly legible.
If our examiners can’t clearly read your handwriting, this may require our team to reach out for clarification, which in turn may delay the processing of your claim.
You’ve included any other supporting documentation that may be required for your specific claim.
Your claim is not complete without the official mandatory or precautionary order of quarantine or isolation. If we don’t receive the order with your claim submission, your claim may be denied. If our examiners can’t clearly read your handwriting, this may require our team to reach out for clarification, which in turn may delay the processing of your claim.
All pieces are submitted together at the same time.
If you submit pieces of your claim in separate emails or under separate cover through the mail, each email would be like a separate, incomplete claim submission!
For example, if you haven’t gotten back the Employer’s Statement section from your employer yet, please don’t send what’s been completed so far and the Employer Statement separately later. This will not help get your claim in line sooner and will actually have the opposite effect.
So, please make sure you send everything together at one time, regardless of submission method.
If you chose to submit via email, you can snap a picture of each page and attach multiple files to 1 email.
When submitting by email, your message is less than 10MB.
Only submit your claim through one method.
Please do not submit your claim multiple ways, like email and fax. This would log your claim twice and your claim would compete with itself. Pick one and done!
This is the best way to submit your initial claim. We advise you to go through this Checklist section before you upload your files.
In short: Please make sure everything is completed, legible, and submitted together at one time.
Claims are processed in the order they are received, and cannot be reviewed by an examiner unless everything is complete. So, if you are missing a portion in your submission, your claim cannot go into the processing queue until you submit everything that’s needed. This may result in delays processing your claim as we must request the missing information and allow time for the missing information to be returned, prior to issuing a decision.
Submitting Your Claim
Claims are processed and reviewed in the order they are received and logged. To help save time on getting your claim “in line” to be reviewed, we recommend you email or fax it, as it then won’t need the additional step of being digitized on our end:
You can also mail your completed claim package to:
COVID-19 Quarantine Claims
1225 Franklin Ave, Ste., 475
Garden City, NY 11530