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How Long Does It Take to Get Approved for Continued Edd Disability After Doctor Recertification

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California State Disability Insurance (SDI)

Frequently Asked Questions

SDI is an insurance program run by the California Employment Development Department that pays weekly benefits of 55% of your average wages for up to a year if you are unable to work because you:

  • Have a non-work-related illness or injury
  • Are pregnant, or
  • Need to take Paid Family Leave (PFL) to care for a sick relative or to bond with a new child.
    • Note: PFL only provides benefits for up to eight weeks.

The program is paid for by SDI taxes that are taken out of most employees' paychecks. If you are self-employed or a business owner, you can pay to get Elective Coverage, which only provides benefits for 39 weeks instead of a year.

COVID-19 and SDI/PFL

If you are sick due to COVID-19, you may qualify for SDI benefits. If you are caring for somebody who is sick due to COVID-19, you may qualify for PFL. See EDD's questions and answers about COVID-19 and the state of California's chart of all the different benefits that may help families impacted by COVID-19.

To get help with questions about the State Disability Insurance (SDI) program, including Paid Family Leave (PFL), you need to contact the Employment Development Department (EDD) of California. EDD provides a list of ways to contact them about SDI or PFL, including online chat, phone numbers, and office locations.

Tip: If you are contacting EDD by telephone, consider calling one of the non-English phone numbers -- it can be quicker to get through on those phones, and the people who answer them know all about SDI and PFL, and speak English in addition to the other language.

Note: DB101 cannot answer questions about your SDI claim. If you have questions, please contact EDD.

Employees pay for State Disability Insurance through a small SDI tax (1.1% of earnings) that is automatically taken out of their paychecks. That money is put into a fund, and used to pay for SDI benefits (including Paid Family Leave). People who are self-employed or business owners can choose to buy elective coverage by paying premiums based on their profits from the previous year.

Most California employees are covered by SDI.

Some groups of employees are not covered, including:

  • Interstate Railroad workers
  • Some domestic workers
  • Most government employees
  • Some employees of non-profit organizations
  • Self-employed workers or business owners who do not pay for elective coverage

Paid Family Leave (PFL) is part of the State Disability Insurance (SDI) program. PFL replaces some of the income you lose when you miss work to care for a sick relative or bond with a new child, for up to eight weeks in a year. Your benefit amount is calculated the same way as SDI, but there's a different form to apply for PFL.

Note: Before July 1, 2020, you could only have six weeks of PFL per year.

The SDI program generally pays 55% of the average wages you earned before the start of your disability. To calculate your average income, SDI looks at a yearlong period that starts around 17 months before your disability, and ends around 5 months before your disability. Those 12 months are called your base period. SDI divides your base period into 4 quarters and uses the quarter when you had the highest wages to figure your average income, and your benefit amount.

Learn more about Calculating SDI Benefits, and check the chart of Weekly Benefit Amounts.

For SDI or PFL benefits, your base period is the 12 months from roughly 17 months to roughly 5 months before the start of your disability.

In 2022, the base periods are:

Claims beginning in the months of January, February, or March of 2022:
The base period is the 12 months from October 1, 2020 to September 30, 2021.

Claims beginning in the months of April, May, or June of 2022:
The base period is the 12 months from January 1, 2021 to December 31, 2021.

Claims beginning in the months of July, August, or September of 2022:
The base period is the 12 months from April 1, 2021 to March 31, 2022.

Claims beginning in the months of October, November, or December of 2022:
The base period is the 12 months from July 1, 2021 to June 30, 2022.

It's a little complicated. The simple answer is that your benefit period usually ends on the date your medical provider lists on your claim form, saying you should be able to work by that date. After that date, if you still can't work because of your disability, you and your medical provider can ask for a longer benefit period.

However, SDI is designed to replace your income for up to 52 weeks of missing work because of your disability (39 weeks for elective coverage and 8 weeks for Paid Family Leave). You can get SDI benefits of up to 52 times your weekly benefit amount, if your medical provider certifies that you still can't work because of your disability.

If you can go back to work part-time or get other income before your benefit period ends, your weekly payment might go down, and you can get benefits for longer than 52 weeks, until you get the total amount you qualify for.

For example, Sam gets an SDI benefit of $200 a week, and qualifies for up to $10,400 in total SDI payments ($200 x 52 = $10,400). After 6 months, Sam has gotten $5,200 in benefits, or half his total. Sam goes back to work part-time, and his weekly benefit drops to $200 a week. His medical provider says Sam continues to be unable to work full time because of his disability, so Sam keeps getting his $200 weekly SDI payment for another 12 months, until he reaches his $10,400 limit.

SDI gives cash payments to employees who are unable to work because of a non-work-related disability, and SDI defines a disability as "... an illness or injury, either physical or mental, which prevents you from performing your regular and customary work." The definition also includes elective surgery, pregnancy, childbirth, or other related medical conditions. Your medical provider has to certify that your condition meets this definition.

To get Paid Family Leave because you are caring for a sick relative, the relative has to have a mental or physical condition that requires at-home care or in-patient care in a hosptial, hospice, or residential medical facility, with continuing treatment by a doctor or other health care provider.

No. SDI has no limits on what you can own or have in the bank.

There is a seven-day waiting period, which means you won't get any SDI benefits for the first week you're off work because of a non-work-related injury or illness. Benefits start on the eighth day. It typically takes SDI 14 days to process an application, so you usually start getting your benefit payments two weeks after you file your claim.

Note: There is no waiting period for Paid Family Leave (PFL).

California State Disability Insurance (SDI) is a state program that provides short-term benefits (up to a year) if you can't work because of a non-job-related injury or illness. Employees pay into the system through SDI taxes that are taken out of their paychecks. People who are self-employed or business owners can choose to pay for elective coverage. SDI covers a wide range of disabilities lasting more than seven days. It also offers Paid Family Leave (up to eight weeks) for those who are caring for a sick relative or bonding with a new child.

Social Security Disability Insurance (SSDI) is a federal program giving long-term cash benefits to people who have paid into the system (through income taxes while working for at least a minimum amount of time) and can't work because of a disability.

Supplemental Security Income (SSI) is a federal program providing long-term cash benefits to low-income people who have a disability, are blind, or are 65 or older.

To qualify for SSDI or SSI, the disability be a total disability lasting for at least 12 months (in a row) or that can be expected to result in death. The person must not only be unable to do his or her previous work, but also that he or she cannot -- considering age, education, and work experience -- do any other kind of work that exists in the national economy.

Yes. It's possible to qualify for California's State Disability Insurance (SDI) while you are on one or both of the federal programs, Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). However, getting SDI benefits might make your SSI or SSDI benefits either go down or stop altogether.

You do not have to reapply. However, you must tell SDI immediately if you:

  • Go back to work part time or full time
  • Recover from your disability, or
  • Get any other type of income.

You must also imemdiately report the death of a person getting SDI payments.

At certain times SDI asks you to "certify" (fill out a form online or by mail) that you still qualify for benefits, and if you do not do this your benefits stop. If you are getting automatic payments, you are asked to certify after 10 weeks of getting benefits. If you are not getting automatic payments, you have to fill out a certification form every two weeks.

Once you are on SDI, as long as you are still unable to work because of your disability your benefit payments will continue up until the "return to work" date your medical provider listed on your application. If your disability lasts past that date, you and your medical provider must ask to extend your benefit period. SDI benefits replace up to 52 weeks of lost income, but if you get a partial benefit you might get payments for longer.

For details, see How long does the SDI benefit last?

The SDI application does not require any sort of proof of citizenship or immigration status.

Yes. You can get a partial or full benefit if you are working less than your regular hours.

No. You cannot get Unemployment Insurance and SDI benefits at the same time. You should consider applying for Unemployment Insurance if you are now able to work and looking for work. You should apply for SDI if you are unable to work because of a non-work-related disability.

If you can go back to work full time, you no longer get SDI benefits. If you return to work part-time, SDI looks at how much your SDI payments and your part-time wages are when added together. If that is less than what you earned before the start of your disability, you continue to get your full SDI benefit. However, if your SDI benefit added to your part-time wages is more than what you earned before your disability began, your SDI payment may go down.

For example, Sam earned $1,000 a week before his illness, and now gets $600 a week from SDI. After several months he's able to go back to work part-time, and earns $500 a week. His $600 SDI payment plus his $500 in wages is $1,100, which is more than the $1,000 Sam earned before he got sick. So his SDI payment drops to $500, but he continues to get this partial SDI payment.

If you get a partial SDI benefit, you might get SDI payments for more than the 52 week maximum (39 weeks for elective coverage). For details, see How long does the SDI benefit last?

You must file your claim between 9 and 49 days after the start of your disability. You cannot submit your application until the 9th day, and if you wait too long you may lose your benefits. If you file your claim after the 49th day, include a letter explaining why you couldn't submit your claim on time.

Yes. For a pregnancy without complications, the benefit period is generally from four weeks before your due date to six weeks after your delivery. If your pregnancy prevents you from working before or after that period, your doctor has to explain why on the claim form.

Note: This article focuses on SDI for people with disabilities and Paid Family Leave (PFL) for people taking care of a person with a disability. If you have questions about Pregnancy Disability Leave, contact the EDD.

Learn more

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Source: https://ca.db101.org/ca/programs/income_support/sdi/faqs.htm

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