Learn more about NY DBL and NY PFL
Sun Life NY PFL claim forms
PFL Maximum Weekly Benefit
The new COVID-19 Quarantine Order DBL and PFL benefits are available after the exhaustion of any applicable paid sick time.
Paid Sick Leave law and Amendments to Statutory Disability and Paid Family Leave laws
The New York COVID-19 Quarantine Order legislation that was signed by the Governor of New York on March 18, 2020 provides for paid sick leave and paid statutory disability (DBL) and paid family leave (PFL) benefits for workers who are unable to work due to an individualized mandatory or precautionary order of quarantine or isolation related to COVID-19 as issued by the State of New York, the Department of Health, local Board of Health or any government entity duly authorized to issue such order. The COVID-19 Quarantine Order PFL benefits are also available for employees who must take time off to care for a minor dependent child who is subject to a Quarantine Order.
The law, which went into place on March 18, 2020, is intended to address the hardship faced by persons out of work due to quarantine or isolation orders.
If you have New York Disability Benefits Law and Paid Family Leave coverage with us and you are a private employer (not public) with fewer than 100 employees in total, (nationally, by FEIN), your employees who are subject to an individualized precautionary or mandatory order of quarantine or isolation related to COVID-19 (Quarantine Order) may qualify for the special Quarantine Order DBL and PFL benefits. Special COVID-19 Quarantine Order PFL benefits may be available for employees caring for minor dependent children who are subject to these same types of orders. Additional scenarios may qualify an employee for regular DBL or PFL benefits or for unemployment insurance.
Call us. If you have questions or think your employees may qualify for benefits, call Client Services Support at 800-247-6875, Monday - Friday, 8 a.m. to 8 p.m. ET. (Employees can call Member Services at the same number.) Our team can talk with you or your employees and can provide the appropriate claim forms.
Be informed. Employees may qualify for the COVID-19 Quarantine Order related to DBL and PFL benefits, the regular DBL/PFL benefits or unemployment. The law also requires most employers to provide paid sick leave. Some quick things to know:
All employers must provide unpaid leave until the end of the Quarantine Order. An employers’ obligation to provide paid sick leave to an employee who is subject to a Quarantine Order varies by employer size.
Quarantine Order Paid Sick Days
≤10 EEs with ≤$1 million net 2019 income
≤10 EEs with > $1 million net 2019 income
All Public Employers
After paid sick time, certain employees can file a claim for NY Statutory Disability benefits (DBL). These special new DBL benefits are only available to employees of private employers with fewer than 100 employees.
For employees who are eligible for the COVID-19 Quarantine Order DBL and PFL benefits, the law changes the definition of disability to include time the employee is unable to perform the regular duties of their employment as a result of an individualized Quarantine Order and when the employee exhausts any applicable paid sick leave time, as identified above. While eligible employees have to exhaust paid sick leave required under the act before they can file for DBL, they become immediately eligible and will not be subject to a waiting period for DBL.
After paid sick time, certain employees can file a claim for NY Paid Family Leave Benefits (PFL). The new COVID-19 Quarantine Order DBL and PFL benefits are available after the exhaustion of any applicable paid sick time.
The law defines “family leave” under PFL to include any leave taken by an employee from work (1) when an employee is subject to an individual Quarantine Order or (2) to provide care for a minor dependent child of the employee who is subject to a Quarantine Order. Under this amendment, employees may be able to collect both DBL and PFL benefits at the same time, something that is ordinarily prohibited under the law.
The NY Worker’s Compensation Board has advised Sun Life that you should count all full and part time employees, including those who work outside of New York. Employees who work outside of New York are not eligible for the COVID-19 Quarantine Order benefits but they are to be counted when determining the nature of the benefits that the employer must provide to its New York-based employees.
New York State has issued guidance on how to obtain an order of quarantine.
The Guidance advises that individuals should contact their Local Health Department (LHD) to obtain the Quarantine Order. If the LHD is unable to immediately provide an order, the employee may submit an attestation from a licensed medical provider that has treated the employee or the employee’s minor child attesting that the employee or the minor child qualifies for the order. That documentation may be submitted with their request for the COVID-19 Quarantine Order DBL and PFL benefits. The guidance also advises the employee that must follow up with the LHD to obtain the Quarantine Order and they must submit it to their insurance carrier as soon as it is available. The guidance makes clear that to be eligible for the COVID-19 Quarantine Orders they must submit the Quarantine Order within 30 days.
School closure alone, without an individualized Quarantine Order, is not a qualifying PFL claim event. That is, if a child’s school is closed in order to promote social distancing and minimize the spread of COVID-19, that is not a qualifying event for the COVID-19 Quarantine Order benefits. However, if a school is closed because of an individualized health concern and there is an applicable Quarantine Order, this may be sufficient to qualify for the COVID-19 Quarantine Order benefits. The Governor’s website advises that employees unable to work because of school closings that are not attributable to a Quarantine Order may be eligible for unemployment.
For every COVID-19 Quarantine Order Paid Family Leave claim an employee must submit the Request for Paid Family Leave (Form PFL-1). Additionally, depending on the type of COVID-19 Quarantine Order leave he or she is taking they will need to submit either the Request for COVID-19 Quarantine Leave for Yourself or the Request for COVID-19 Quarantine Leave for Minor Child. Employees will also need to submit the mandatory or precautionary quarantine or order of isolation issued by the State, department of health, local board of health, or government entity. See above Q&A about quarantine orders.
Please see the answer above about how to apply for a Quarantine order and what steps to take if you are having difficulty obtaining an order.
These COVID-19 Quarantine Order NY DBL and PFL benefits are payable concurrently and the employee may not collect benefits that exceed $840.70 in PFL and $2,043.92 in DBL benefits per week.
The NY Worker’s Compensation Board has advised that the PFL benefit, if applicable, will be calculated first and that the DBL benefit, if applicable, will be a top up. The COVID-19 Quarantine Order DBL benefit will be paid at 100% of the employee’s average weekly wage up to $2,043.92. The aggregate weekly maximum benefit is $2,884.62 per week.
Please note that the eligibility requirements and maximum durations under the coverage still apply.
These are substantial increases in the amount of benefits, and a special exception to the ordinary rule that an employee cannot collect both NY DBL and NY PFL benefits at the same time.
Employees are required to submit a Quarantine Order to be eligible for the COVID-19 Quarantine Order NY DBL and NY PFL COVID-19 benefits. Please see the guidance above about how to apply for a Quarantine Order and what steps to take if you are having difficulty obtaining an order. If an employee is not able to provide to a qualified COVID-19 Quarantine Order but is unable to work due to symptoms of COVID-19 or having been diagnosed with COVID-19, he or she may be eligible for the regular statutory disability benefits that cover a disabling illness. They will need to submit appropriate medical documentation to demonstrate disability.
As noted above, employees are required to submit a Quarantine Order to be eligible for the COVID-19 Quarantine Order NY DBL and NY PFL COVID-19 benefits. Please see the guidance above about how to obtain a Quarantine Order and steps to take if you have having difficulty obtaining such an order.
If your employee is not able to submit a qualified Quarantine Order but is unable to work because they are taking care of a covered family member who is demonstrating COVID-19 symptoms or who has been diagnosed with COVID-19, they may be eligible for the regular statutory paid family leave benefits that cover absences to care for certain family members with a serious health condition. They will need to submit appropriate medical documentation to support the need for leave.
On March 27, 2020 the NY Worker’s Compensation Board adopted an emergency revision to its “regular” PFL regulations to state that a diagnosis of COVID-19 qualifies as a serious health condition. The most significant impact of this regulation is that an employee can obtain regular NY PFL benefits without having to submit a Quarantine Order. This emergency regulation is in effect for 90 days unless extended.
If you have New York Disability Benefits Law and Paid Family Leave coverage with us, please know that the State of New York has mandated a 60-day premium grace period effective March 30, 2020 for employers facing financial hardship as a result of the COVID-19 pandemic. Should you need it, there is no need to contact us as it will be applied automatically.
* This checklist and suggested content are not to be considered legal advice. We recommend that Clients speak with legal counsel specializing in labor and employment law to ensure your organization has met all of the requirements under the New York Workers’ Compensation Laws.
In New York, Disability Benefit Law policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 06P-NY-DBL.
SLPC 30706 11/21 (expires 11/23)