Form DB-450 Notice and Proof of Claim for Disability Benefits - New York

What Is Form DB-450?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is form DB-450?
A: Form DB-450 is a Notice and Proof of Claim for Disability Benefits in New York.

Q: What is the purpose of form DB-450?
A: The purpose of form DB-450 is to notify your employer's disability benefitsinsurance carrier of your disability and file a claim for benefits.

Q: Who needs to use form DB-450?
A: Employees who are unable to work due to a non-work-related illness or injury and want to claim disability benefits in New York need to use form DB-450.

Q: What information is required on form DB-450?
A: Form DB-450 requires information such as your personal details, employer information, details of the disability, and medical information.

Q: What should I do after completing form DB-450?
A: After completing form DB-450, you should submit it to your employer's disability benefits insurance carrier, along with any required documentation.

Q: Is there a deadline for submitting form DB-450?
A: Yes, form DB-450 should be submitted within 30 days of the first day of your disability, or you may lose your right to benefits for that period.

Q: What should I do if my claim for disability benefits is denied?
A: If your claim for disability benefits is denied, you have the right to request a hearing before an Administrative Law Judge at the New York State Workers' Compensation Board.