The Notice and Proof of Claim for Disability Benefits, better known to HR professionals as the DB-450, has been revised. The New York State Workers’ Compensation Board wants to simplify the filing process and capture more information earlier in the disability benefits claim process.
Previously there were two different disability claim forms: The Notice and Proof of Claim for Disability Benefits (Form DB-450) and the Notice and Proof of Claim for Disability Benefits of Unemployed Claimant (Form DB-300). The information from both forms has now been combined into a revised Form DB-450. Form DB-300 has been eliminated. Claimants will now use the revised Form DB-450 to file all disability benefit claims regardless of their employment status.
What has changed on Form DB-450? The changes include:
- Clearer filing instructions;
- The instructions include information on how to locate the mailing address for submitting the form to the appropriate insurance carrier or the Workers’ Compensation Board; and
- The addition of questions to collect information regarding whether the claimant’s disability is the result of a motor vehicle accident.
The new Form DB-450 is available on the New York State Workers’ Compensation Board’s website. Use of the revised Form DB-450, Notice and Proof of Claim for Disability Benefits, is effective immediately. The old form will continue to be accepted until December 22, 2017.
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