About Insurance

Women who have recently had a baby or surgery, and will be out of work for a period of time as a result of these conditions, may be eligible for New York State Disability (NYSD). Most employers are required by state law to provide insurance coverage for these Disability Benefits. Some women may also have private disability policies that provide benefits after childbirth or surgery.

Steps to Take

To file for Disability Benefits, you will need to obtain the necessary forms from your employer's Personnel Office or HR Department. Disability claim forms usually require information and signatures from you (the patient), your employer (including recent wage information) and your doctor (WGCA). Please bring these forms to our office at least one week before your due date or surgery date. Please do not give these forms to your doctor; you may leave them for the Disability Secretary at the Front Desk.

As a general rule, disability forms should not be submitted more than two weeks before your disability begins (surgery date, or deliver date) to avoid denial by the insurance company. A denial may delay the receipt of your benefits, and may require that you resubmit your forms. If your claim is denied, please contact our office immediately so that we can work with your insurance company to resubmit updated forms, if necessary.

Filling Out the Forms

It is important that you fill out the portion indicated for "Claimant Information." - Part A. If you are given a standard DB-450 disability form, question #7 must be answered, or your disability benefits may be delayed. Download and print a copy of the DB-450 , if you need one.

For pregnant patients, once you have delivered your baby, you should receive a supplementary form from your insurance company. Please bring or send that form to our office so we can update the information we have already given them (i.e. your delivery date and type of delivery). Additionally, if you had a baby boy and he had a circumcision, please call or send a note to our office with his full name, insurance company including contract number, and the name of the subscriber on the contract.

Please contact your insurance company to add your baby to your contract. Most insurance companies require that your baby be added t within 30 days of birth, in order to pay claims these services. If you do not add your baby to an insurance policy, you may be responsible for the baby's bills and your claims may be denied.

Other Information

In the event your disability needs to be extended, a note from your doctor will be mailed to you, which you must then forward to your employer. You need to be aware that if your insurance company does not agree with our medical opinion for the extension, you may not be paid.

Please note, your sick time is not considered to be part of your disability. Physicians can not give an excuse for sick time extensions.

The insurance company typically covers:

  • Six weeks after delivery for a normal vaginal delivery
  • Six to eight weeks after a cesarean section delivery (Some companies do not pay the eight weeks for the cesarean section.)
  • Some policies cover 1-2 weeks prior to delivery, please check with your employer to determine these benefits.

If your company employs over 50 full-time employees you may want to inquire about your rights under the Family Medical Leave Act (FMLA).

If you have any questions, please call our office and ask to speak with the secretary who handles Disability insurance. We are here to help.