DB-300: Notice and proof of Claim for Disability Benefits by Unemployed Claimant

Use the DB-300 form to apply for New York State disability benefits if you became disabled or sick after more than four weeks of unemployment. To apply for these benefits, you and your healthcare provider must complete a DB-300 form, which is also known as a Notice and Proof of Claim for Disability Benefits Form by Unemployed Claimant. Print this form and apply for disability benefits now.

We urge that you not submit this form until it has been reviewed by an attorney who is aware of all the facts and circumstances of your matter.

Download the DB-300 form.

Caution: These videos contain general information and are not intended to replace individual legal advice from a retained attorney. We are not your attorney until a written retainer has been signed by us for a specific issue or matter. The forms shown in these video may be slightly different than the downloadable form due to form updates and modifications by the DMV.