Know Your Rights: State Disability Insurance

Know Your Rights: State Disability Insurance

S. E. Williams | Voice Executive Editor

State Disability Insurance (SDI) which is funded through state-mandated payroll deductions, covers about 13 million California workers, and provides partial wage replacement of approximately 55% of income for individuals currently in the labor market.

SDI encompasses and provides coverage for two programs: (1) The Disability Insurance provides partial wage replacement benefits for up to 52 weeks per claim. (2) Paid Family Leave provides partial wage replacement benefits for up to 6 weeks per claim within a rolling 12-month period.

The SDI programs are administered through the Employee Development Department (EDD). The partial wage replacement is provided when workers are unable to perform their regular or customary work due to physical and mental injuries, illnesses and other health conditions.

There are however workers in certain jobs who are not eligible to receive SDI including certain domestic workers, independent contractors, election campaign workers and students who work for their school.

In addition, there are a few employers permitted by the state to opt out of SDI and instead, offer comparable benefits through a private plan.  If you are unsure as to whether your employer participates in the SDI program it is recommended you ask your HR department or manager for information.

Requirements for Receiving SDA

To qualify you must meet the definition of “disability,” as defined below and be under the ongoing care of a licensed health care provider or authorized religious practitioner.

Time Limit for Applying

You must apply promptly, and you must have either been working or looking for work when your disability began. An application must be submitted within 41 days of the date you were first unable to work or stopped looking for work due to your disability.  If, however you miss the deadline, you might still be eligible if you have a good reason for being late. For example, if you misunderstood something that the EDD told you on the phone and did not realize you were eligible for SDI until after the deadline had passed, it is possible your application will still be accepted. 

Base Period

Another element of qualification is an applicant must have sufficient past earnings in his/her “base period.” The base period is the one-year period that began about 15 to 17 months before the date of your application for SDI benefits. Each base period is divided into three-month time periods called “quarters.”  To be eligible for SDI benefits, you must have earned at least $300 in one of the quarters of your base period.  To find the base period for your SDI claim, use the following table:

If you filed your claim in … Your base period is the 12-month period ending the previous …
January, February, March September 30
April, May, June December 31
July, August, September March 31
October, November, December June 30

What Type of Disabilities Qualify for SDI?

Any mental or physical condition that stops you from performing your usual work; or, if you are unemployed, any condition that stops you from being able to look for work (for more than one week) is a disability that qualifies for SDI.

This can include physical illness, mental illness, injuries, surgery, pregnancy, childbirth, and being in treatment for drug or alcohol abuse.  However, a licensed health care professional or an authorized religious practitioner must sign a form declaring your disability is preventing you from working.

If Unemployed When You Become Disabled

If you were actively looking for work when your disability began, and you have earnings in your base period, you are still entitled to SDI. 

How to File a Claim

It is more convenient to file a claim online through the EDD’s website. You can also file your SDI claim by mail. You will have to request that a copy of the application be mailed to you via the EDD website or by calling the EDD at 1-800-480-3287 [English] or 1-866-658-8846 [Spanish]. Complete the application and  mail it to the EDD office closest to your residence.

No Money in Your Base Period

If I do not have money in my base period because you were unemployed before filing, you have two options. First,  if you have an unexpired claim for unemployment insurance benefits when you are seeking SDI, then you may use the base period you used for your unemployment insurance claim. Second, if you were unemployed during any quarter of your base period – meaning out of work for 60 or more days and looking for work – you may disregard that quarter and begin your base period three months earlier than the period set forth in the above chart.  For each quarter you were unemployed, you may go back another quarter.

How Are Benefit Amounts Determined

Benefit amounts are calculated based on the amount of earnings one had during the  highest-earning quarter of the base period and is about 60-70 percent—depending on income—of the applicant’s regular earnings.  SDI payments are processed every two weeks. In addition, the entire amount a person can receive in SDI benefits from a single claim may not exceed the total amount of wages one earned during their base period.

Workers’ Compensation

If a person is injured on the job, he/she should qualify for temporary income replacement through Workers’ Compensation with two exceptions.

First, if the amount of money paid to you from your Workers’ Compensation benefits is less than what SDI benefits would pay, then you may make a claim for SDI to cover the difference. Second, if there is a delay in your Workers’ Compensation application. For example, if your employer disputes your eligibility, or if you are denied an appeal) you may apply for SDI benefits until the dispute is settled. If your Workers’ Compensation claim is later approved, you will have to pay back the SDI you received so that you do not get double benefits for the same period.

Are the Undocumented Eligible for SDI

Yes. If an individual is otherwise qualified, he/she cannot be denied benefits because they are or were undocumented. If you paid into the program you have a right to collect your benefits.

How Long Can an Individual Draw SDI?

You can receive SDI benefits for as long as you remain disabled, up to a maximum of 52 weeks. In some cases, however even though an individual is otherwise qualified he/she might not receive a full year of SDI because they do not have enough money in their account for a full year of benefits. EDD will provide a statement when you apply advising you of how much money is in your reserve account.

If Your Disability Lasts Longer than 52 Weeks

When your disability extends beyond 52 weeks, you may be eligible for Social Security Disability Insurance (“SSDI”) or Supplemental Security Income (“SSI”), depending on the type of disability and how severe it is. See the Social Security Fact Sheets regarding these programs.

Source:legalaidatwork.org

 

About The Author

S.E. Williams

Stephanie E. Williams is an award winning investigative reporter, editor and activist who has contributed to several Inland Empire publications. Williams spent more than thirty years as a middle-manager in the telecommunications industry before retiring to pursue her passion as a reporter and non-fiction writer. Beyond writing, Williams’ personal interests include stone-carving, drumming and sculpting.

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