Paid medical leave in New York comes through two separate state programs that most private-sector workers can tap. Statutory Disability Benefits, known as DBL, replace part of your pay when a non-work illness or injury keeps you off the job. Paid Family Leave, or PFL, pays you to care for a family member with a serious health condition. Each has its own benefit rate, duration, and paperwork, but they share a single ceiling: 26 weeks of combined leave in any 52-week period.
What Each Program Covers
DBL is for your own health. A knee surgery, pneumonia, pregnancy complications, a chronic condition flaring up — if it keeps you from working and it didn’t happen at work, DBL is the program. Injuries or illnesses that arose on the job go through workers’ compensation instead, which is a different system with different rules.
PFL covers time away to care for a family member with a serious health condition, meaning an illness, injury, or disability involving either inpatient hospital care or ongoing treatment by a health care provider. The list of qualifying family members is broader than most people expect:
- Spouse or domestic partner (legal registration is not required for domestic partners)
- Child or stepchild, including anyone you have legal custody of
- Parent or stepparent
- Parent-in-law
- Grandparent
- Grandchild
- Sibling
PFL also covers bonding with a new child and certain military family needs, but for medical situations the caregiving piece is the point.1New York State Paid Family Leave. Paid Family Leave for Family Care
Who Qualifies
Eligibility turns on your hours and your tenure. If you regularly work 20 or more hours per week, you qualify after 26 consecutive weeks of employment. If you work fewer than 20 hours per week, you qualify after 175 days of work.2Paid Family Leave. Paid Family Leave and Other Benefits
Nearly every private employer in New York is required to carry both DBL and PFL coverage, regardless of size. A business with a single employee is covered. Nonprofits are covered. Certain domestic workers are covered. Public employers are the main exception; they are not automatically required to participate, though they can opt in.3New York State Workers’ Compensation Board. Disability and Paid Family Leave Benefits Coverage Requirements
How Much You Get Paid, and For How Long
Disability Benefits
DBL pays 50% of your average weekly wage based on your last eight weeks of work, capped at $170 per week. That cap has been frozen for decades, so for most workers the actual benefit lands at $170. You can collect DBL for up to 26 weeks in any 52-week window.4New York State Workers’ Compensation Board. Workers Disability Benefits
There is a seven-day waiting period. You receive nothing for the first seven consecutive days of disability, and benefits start on the eighth day.
Paid Family Leave
PFL is significantly more generous. It pays 67% of your average weekly wage, capped at 67% of the New York Statewide Average Weekly Wage. For 2026, the maximum weekly benefit is $1,228.53. You can take up to 12 weeks of PFL in a 52-week window.5New York State Paid Family Leave. Wage Benefits Calculator
The Combined 26-Week Ceiling
You cannot collect DBL and PFL at the same time, and together they cannot exceed 26 weeks in any 52-week period. Use 14 weeks of DBL for your own surgery recovery, and you have at most 12 weeks of PFL left. Max out DBL at 26 weeks, and no PFL is available until the 52-week window resets.6New York State Workers’ Compensation Board. Employee Eligibility / Benefits
How to Apply
Both programs are administered by your employer’s insurance carrier, not by a state agency. Your HR department can tell you which carrier holds the policy and usually keeps the forms on hand.
Filing for DBL
For your own medical condition, use Form DB-450. You complete the employee section; your health care provider completes a medical statement with your diagnosis, the date your disability began, and an estimated return-to-work date. Submit the form to your employer’s disability carrier within 30 days of your first day of disability. Missing that deadline can cost you benefits for the period before you filed.7Workers’ Compensation Board. New York State Notice and Proof of Claim for Disability Benefits
Filing for PFL
To care for a family member, use Form PFL-1 to request leave from your employer and Form PFL-4 for your family member’s health care provider to certify the serious health condition. Give the PFL-1 to your employer so they can fill in their section, then send the full package to your employer’s PFL insurance carrier. The same 30-day filing deadline applies.8New York Workers’ Compensation Board. How to Request Paid Family Leave
How Quickly the Carrier Must Answer
Once the carrier has your completed application, it must either pay the claim or issue a written denial within 18 calendar days, or by your first day of leave, whichever is later. The denial has to explain why the claim was rejected and tell you how to appeal.9New York Paid Family Leave. Handling Requests
If Your Claim Is Denied
A denial is not the end. For PFL, you can request arbitration by a neutral arbitrator within six months of the denial, filing at nyspfla.com or by mail. The filing fee is $25, refunded if the arbitrator rules for you. Include the denial notice, your original PFL request, and any supporting evidence.10New York Workers’ Compensation Board. Notice of Total or Partial Denial of Request/Claim
DBL disputes go through the Workers’ Compensation Board rather than private arbitration. You can file a claim with the Board if you believe benefits were wrongly denied.
Job Protection While You Are Out
PFL comes with strong job protection. When you return, your employer must reinstate you to your same position or a comparable one, and cannot retaliate against you for requesting or taking leave. Retaliation includes termination, pay cuts, benefit reductions, and disciplinary action. If your employer refuses to restore your position, you can file a Formal Request for Reinstatement, and if that fails, a discrimination complaint with the Workers’ Compensation Board. A judge who finds a violation can order reinstatement, back pay, attorney’s fees, and penalties of up to $500.11New York State Paid Family Leave. Your Rights and Protections
DBL does not carry the same explicit reinstatement guarantee. If you also qualify for federal FMLA leave running alongside DBL, that federal law provides its own job-protection layer.
Health Insurance During Leave
If your employer provides health insurance, your coverage continues during PFL on the same terms as if you were still at work. You still pay your usual share of the premium, and if the premium changes while you are out, you pay the new rate.12New York Codes, Rules and Regulations. 380-7.3 Health Insurance During Paid Family Leave
How Federal FMLA Fits In
The federal Family and Medical Leave Act provides up to 12 weeks of unpaid, job-protected leave per year for your own serious health condition or to care for a family member. FMLA pays nothing, but it guarantees reinstatement to the same or an equivalent position with the same pay, benefits, and working conditions.13Office of the Law Revision Counsel. 29 USC 2614 – Employment and Benefits Protection
FMLA eligibility is narrower than New York’s. You need 12 months of employment, at least 1,250 hours worked in the past year, and your employer must have 50 or more employees within 75 miles of your worksite.14U.S. Department of Labor. Family and Medical Leave (FMLA)
When you qualify for both FMLA and New York PFL, the two typically run concurrently, meaning the 12 weeks of PFL and the 12 weeks of FMLA overlap rather than stack. The practical benefit is that you get paid through PFL while gaining the federal job-protection guarantee. For DBL situations, FMLA can supply the job protection that DBL alone does not explicitly provide.
Taxes on Your Benefits
Starting with tax year 2025, the IRS clarified federal tax treatment of state paid leave through Revenue Ruling 2025-4. PFL benefits are included in your federal gross income and reported on Form 1099. The state does not withhold employment tax on them, so you may owe when you file if you have not planned ahead.15Internal Revenue Service. Revenue Ruling 2025-4
DBL is split. The portion of benefits attributable to your own payroll contributions is excluded from federal gross income; the portion attributable to your employer’s contributions is taxable. Because the employee share is small, most of the benefit is likely taxable. Setting aside part of each payment, or asking your tax preparer about estimated payments, can prevent a surprise at filing time.
Where Paid Sick Leave Fits
Separate from both DBL and PFL, New York requires employers to provide paid sick leave for shorter-term needs: a doctor’s appointment, a few days with the flu, caring for a sick child. Sick leave is the first line of defense for routine medical situations. DBL and PFL are designed for longer absences, when sick leave runs out or the condition is serious enough to keep you away from work for weeks.16NY.gov. New York Paid Sick Leave