Sheila McGarrigle

Top 3 Must See: Paid Family Leave vs. statutory Disability

June 26, 2018

PFL dbl pfl

Top 3 Must See — Q&A on DBL vs. PFL

Since New York Paid Family Leave (PFL) was added to New York’s statutory Disability policy (DBL, short for Disability Benefits Law) as a rider, there are a lot of questions about how they relate, compare, and interact. While there is some overlap between the two, they are, at their cores, distinctly different in that PFL is for time off from work spent for a family member, and DBL is specifically for an employee’s own serious illness or injury.

Some of the biggest differences between DBL and PFL include:

  • job protection (PFL has it, DBL doesn’t),
  • pay rate (in 2018, DBL maxes out at $170/week, PFL at $652.96/week), and
  • leave time (in 2018, DBL provides up to 26 weeks in a 52-week period, PFL offers up 8 weeks in a 52-week period – however, the combined time out on DBL and PFL cannot exceed 26 weeks in a 52-week period).

With this general understanding in mind, let’s look at the top 3 questions we’ve received about DBL vs. PFL from real people like you.

1. If I’m eligible to take DBL, I’m already eligible for PFL, right?

Not necessarily. While DBL and PFL are related, their eligibility requirements are not identical. We’ve summarized those differences in the chart below.

 

DBL

PFL

Full-time definition

Persons working the amount of hours that constitute the specific employer’s normal work week

Persons working 20+ hours/week

Full-time employees

Worked at least 4 consecutive weeks for any Covered Employer(s)

Employed at least 26 consecutive weeks at their current Covered Employer

Part-time employees

Completed at least 25 working days at any Covered Employer(s)

Completed at least 175 days at their current Covered Employer

Personal or domestic employees

Work at least 40 hours/week (if they work 30 or more days in a calendar year for you)

Transferability of qualification period

Yes, if an employee changes jobs from one Covered Employer to another, their time worked at the previous employer counts.

 

However, if their previous job was at an exempt employer without voluntary coverage, they have to satisfy the qualification period at their new Covered Employer.

No. If an employee changes jobs from one Covered Employer to another, their time worked at the previous employer does not count.

What counts towards qualification period

Approved vacation, personal, and sick time.

 

Other time away from work but still considered an employee as long as their PFL coverage is paid for.

What does not count towards the qualification period

N/A

Time out on DBL

 

2. Can I take DBL and PFL at the same time?

No, you can’t take DBL and PFL at the same time, but it is possible to take them consecutively.

For example, if you give birth to a baby, you can take DBL for the first part of your leave to recover from birth (typically 6 weeks for normal delivery and 8 weeks for a C-section), followed by Paid Family Leave to bond with your new child. For more details on how maternity/paternity leave works with both DBL and PFL, check out our Top 3 Questions from February.  

3. Why does my PFL claim take longer to process than my DBL claim?

Because DBL deals exclusively with an employee’s personal injury or illness, there are fewer forms and information to provide and verify. Paid Family Leave gives eligible employees time off for things related to a qualifying family member (bonding with a new child, caring for a seriously ill loved one, handling things related to a family member’s military service), which involves more information, forms, and documentation to provide and verify. Due to those additional verification steps for PFL, NY State gives carriers 18 days (from receipt of fully completed forms including all required documentation) to process a claim. Below is a quick chart showing how DBL and PFL claim turn-around times compare:

 

DBL

PFL

Claim determination turn-around time allowed by law

 4 business days after the latter of:

  • The 14th day of being out on DBL, or
  • Receipt of the claim (fully completed form with all required documentation and statements)

18 days after a fully completed claim is received.

 

We have a handy roadmap here that illustrates what’s required for each type of leave to help make sure employees have all the necessary information before submitting.

 

There are a lot of specifics that differentiate between DBL and PFL. If you’d like to learn more, check out our detailed comparison article here, and sign-up for our updates to stay up to date with all things PFL.

Have more questions about DBL vs. PFL, or other Paid Family Leave topics? Check back soon to see if we cover your question in our next installment, or ask our PFL experts at pflquestions@shelterpoint.com


This blog post is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice. Any PFL information is as of the blog post’s date stamp; it is based on the applicable statutes and regulation,  and may change as regulations evolve or NY State issues guidance regarding Paid Family Leave regulations. Have more questions? Email us at pflquestions@shelterpoint.com
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