Tip:
Highlight text to annotate it
X
If you were hurt in a car and cannot work, there are disability benefits available to
help you get by while you recover. To apply for New York State disability benefits, you
need to complete the Notice and Proof of Claim for Disability Benefits form, which is also
known as the DB-four fifty form. You can pick up a copy of the DB-450 form at the Law Offices
of William Mattar. If you became sick or disabled while employed
or were employed four weeks before you became sick or disabled, you should use the DB-450
form to apply for benefits. If you became sick or disabled after having been unemployed
for more than four weeks, should fill out the DB-three hundred form to apply for benefits.
There are two parts to the DB-450 form. First is part A, which can be completed by you,
the claimant. Second is part B, which must be completed by your health care provider.
To complete part A, you must fill in basic information about yourself, your disability,
your employment history for the last eight weeks, and details about whether you are currently
receiving any other insurance benefits. Part A has twelve sections. Some sections may require
further information based on your answer. After you complete part A, take a few minutes
to read through your answers before you sign the form.
Once you have filled out and checked your part of the DB-450 form, ask your health care
provider to complete part B. They need to provide a statement about your diagnosis,
treatment, and dates of your disability. Your health care provider must fill in all sections
completely and sign the DB-450 form. When both parts A and B are complete, the
DB-450 form needs to be forwarded to your employer to be processed, or go directly to
your employer’s disability insurance carrier. It’s important that you complete your DB-450
form as quickly as possible after you become sick or disabled. The Workers’ Compensation
Board requires that your completed claim be filed (or mailed) to your last employer or
last employer’s insurance company within thirty days after your disability began. If
your claim is being filed later than thirty days after your disability began, you must
attach a statement explaining why you could not file your claim earlier.
If you have questions about how to complete the DB-450 form, we’re here to help. Remember,
when you’ve been hurt in a car, call William Mattar at four four four- four four four four!
Our attorneys focus on auto accident cases.