Claim Help - NY Statutory Short-Term Disability (DBL)

 

Checklist to Get You Started

So, you’re here because you either have an injury/illness that is not caused by your job or you’re expecting a baby; and your condition is NOT related to COVID-19. (Click here if it is).

Ready to submit your DBL claim?

Then download the claim form from the right (or if you’re browsing on a mobile phone – from the bottom)

And follow this handy checklist to help make your claim as smooth as possible.


Your condition is not caused by your job.

If it is caused by your job, please consider filing for Workers’ Compensation Benefits instead. DBL only provides benefits for off-the-job conditions.

You’re already out on disability (injury/illness or pregnancy-related leave).

You cannot file before you’re out on disability, such as filing before giving birth (unless you are on doctor-prescribed, medically necessary bed rest), or before a scheduled medical procedure that would cause you to be unable to work.

Your first full day of disability was no longer than 30 days ago.

If your disability (injury/illness or pregnancy-related leave) began more than 30 days ago, you must file your claim with the Workers' Compensation Board’s Special Fund. You can still use the DB-450 form our website for your convenience, but we cannot accept your claim. Click here for more information.

You are currently employed or have not been unemployed for more than 4 weeks.

If you have been unemployed (including furloughed, temporarily laid off, or out of work because your employer is currently closed) for more than 4 weeks when your disability (injury/illness or pregnancy-related leave) began and you are collecting unemployment benefits, you cannot collect both unemployment and DBL.

If you are not receiving unemployment benefits, you may file your claim with the Workers' Compensation Board’s Special Fund. You can still use the DB-450 form our website for your convenience, but we cannot accept your claim. Click here for more information.

Everything is completed on your DB-450.

All 3 parts must be completely filled out and signed by the respective party. There should be no blank fields left on the form.
  • Part A to be filled out and signed by you.
  • Part B to be filled out and signed by your Health Care Provider.
    Your attending health care provider must certify that your disability or illness prevents you from working.
  • Part C to be filled out and signed by your Employer.

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.


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!
 

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.

 

Completing Your Form

Need help filling out the DB450? Download our DB450 Claims Guide here.

 

 

 

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:

Email: claimforms@shelterpoint.com

Fax: 516-504-6414

You can also mail your completed claim package to:

DBL Claims
ShelterPoint Life
1225 Franklin Ave, Ste., 475
Garden City, NY 11530

 

 

 

What Happens Next?

We get a lot of questions about what happens next. Here’s our collection of FAQs:

Claims will be processed in the order they are received. Once your claim is logged/digitized into our system, you will receive your claim# (via paper mail) - please be patient, this usually takes a couple of business days.

Once you have a claim number assigned, we can view it in our system – and you can track the status of your claim yourself 24/7 using our online claimant portal.
Regardless of your submission method, you will receive mail from us either in the form of the first payment, a request for more information, or a denial notice. This communication will include your claim number.

For the majority of claims, you can generally expect to receive this after about a calendar week after we receive your claim.
If your claim has not made it into our system yet, we won’t be able to look up the claim number for you and we won’t be able to give you a confirmation or tell you your claim number if you call us immediately after submitting your claim. Please allow 2 full business days for your claim to get registered. At this point your claim gets assigned a claim number.
If something is missing we will send a request to you in writing via paper mail. For the majority of claims, you can generally expect this after about a week after we receive your claim. We may reach out via email if you provided your contact information to us on your claim form.

If we have everything we need to review your claim, and it is payable, you should receive your benefit payment in the form of a check, along with any other supplemental updates requested.

 

 

 

My Claim is Approved...

If we have everything we need to review your claim, and it is payable, you will receive mail from us including a check for your first benefit payment. For the majority of claims, you can generally expect to receive this after about a calendar week after we receive your properly and fully completed claim.

DBL regulations require (if your claim is properly completed with all required statements) that your first payment should arrive within 4 business days after either the 14th day of disability or the receipt of the claim, whichever is later.

Thereafter, benefits are payable every 2 weeks, for as long as you are still unable to return to work due to the same condition (for a maximum of 26 weeks). Depending on the condition, we may need to check in periodically to confirm if you are still not able to return to work or if your planned return-to-work date has changed.

Tip: You can track your payment status, when your next check is scheduled, and much more in our claim portal. Your first payment includes your claim number, which you’ll need to log in.

Manage your claim 24/7 online or via our App!
Once you receive your claim#, sign into our claim portal for around-the-clock access to:
  • Find out if you are eligible for benefit payments
  • View your current claim status and see if you need to take any action to assure continued processing of your claim
  • Upload additional forms and documents
  • See when your next check will be sent
  • And much more!
Registration is fast and easy – you just need your:
  • Claim number
  • Social Security Number
  • Valid email address

Online Claims Portal: Shelterpoint.com/claimportal

Claim Portal App:
  

Generally speaking, claims are paid bi-weekly. However, it’s your responsibility to keep us and your employer updated. This includes if you return to work early, or your doctor extends your initial disability period.

During your claim we may send you periodic requests to certify your working status. It’s important to note that until required follow-up documents are received and reviewed, we can’t send the next payment.

Tip: Use our claim portal to upload any additional documents that may be required to keep you claim going.
Yes. While you are on disability, you must be under continuing supervision by a qualified health care provider. We may ask for medical updates and, in certain cases, independent medical examinations to support further benefits.

This means you must accept examinations by a health care provider of our or your employer’s choice when requested. We cannot ask for exams more than once a week. You don’t have to pay for those exams, and they are conducted at a reasonable time and place. If you don’t participate in an exam, this may jeopardize your benefits.

 

 

 

Other FAQs

Yes. Generally, as an eligible employee you don’t lose protection during the first 4 weeks of unemployment (provided you are not eligible for and are claiming unemployment insurance benefits).
You may file for DBL benefits if you are unemployed if you are eligible for and are claiming unemployment insurance benefits.
  • If your disability occurs within 4 weeks after your employment is terminated, benefits are paid by your former employer's insurance carrier.
  • If you become disabled in the period between 4 and 26 weeks after termination, you receive benefits from the Special Fund for Disability Benefits, which is administered by the Workers' Compensation Board (see How do I apply for DBL benefits? for details).
  • Please note, however, that you cannot collect Disability and Unemployment Insurance benefits at the same time.
You may file a completed claim Form DB-450 with the Workers' Compensation Board:

Workers' Compensation Board
Disability Benefits Bureau
PO Box 9029
Endicott, NY 13761-9029
 
If you file your claim late, benefits may be denied for any period of disability prior to 2 weeks before it was filed – unless you can demonstrate that it was impossible to file sooner. And if your claim is filed later than 26 weeks after your disability began, you are not eligible for benefits at all. (Exception: Minors, mentally or physically incompetent people with no guardian may have a longer period in which to file a claim.)
 

 

 

Still have questions?
Our DBL Experts are happy to help. Contact them anytime at: customerservice@shelterpoint.com

Download icon   DBL Claim Forms

To help best serve you, we ask you to make our self-service online tools your first stop for service and support questions:

DB-450 (DBL Claim Form)
Enhanced In-Hospital Rider
Accidental Death & Dismemberment Rider

 

Check status icon  Check My Claim Status

Manage your claim 24/7 online or via our App!
Once you receive your claim#, sign into our claim portal for around-the-clock access to:

  • Find out if you are eligible for benefit payments
  • View your current claim status and see if you need to take any action to assure continued processing of your claim
  • Upload additional forms and documents
  • See when your next check will be sent
  • And much more!

Registration is fast and easy - we just need your:

  • Claim number
  • Social Security number
  • Valid email address

Monitor icon   Online Claims Portal:
Shelterpoint.com/claimportal

Mobile icon  Claim Portal App:
Download Mobile App now!

  

 

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ShelterPoint Life Insurance Company, formerly The First Rehabilitation Life Insurance Company of America.

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