California State Disability Insurance: Everything You Need to Know
The California State Disability Insurance (SDI) program is offered through the Employment Development Department (EDD).5 min read
What Is California State Disability Insurance?
The California State Disability Insurance (SDI) program is offered through the Employment Development Department (EDD). It's a state level version of Social Security Disability Insurance (SSDI), but has more reach than SSDI. The concept behind SDI is to replace income for employees who are unable to work due to pregnancy, illness, time off to bond with a new child, or take care of a sick relative.
Money for this program comes from the income of people who work in the state of California. A small amount is deducted from paychecks and deposited into a state fund. When someone files a claim with SDI, the money for their claim comes from this fund. Benefits are paid every other week and can last up to a year.
The SDI Benefit
SDI pays up to 55 percent of wages for up to 52 weeks, or one year, of your disability. The program looks at your wages over a 12-month period of time to come up with an average wage. The look back starts about 17 months prior to the disability and stops about five months before the disability occurred. SDI calls these 12 months your base period for pay. From there, the agency takes the one-year period and divides it into four quarters, looking for the quarter with the highest earnings. This quarter is the one that SDI uses to decide the amount of the benefit.
Benefit payments generally start within two weeks of filing a claim. Afterward, a check is issued every 14 days until the benefit period expires. Sometimes checks come with a form titled "continued claim certification" The person receiving the benefits has to fill out the form to let the state know if they have gone back to work, received income, and/or indicate if they are able to return to work or not.
SDI sometimes gives the beneficiary more money than they are qualified for. This is known as an overpayment and the beneficiary has the responsibility of paying it back.
Benefits end either on the date that the medical provider stated on the form for disability or when the 52-week period expires. An exception gets invoked when the beneficiary has been employed part-time in the form of an extension of the benefit for longer than 52 weeks. Those who voluntarily go on SDI to take care of personal issues have a maximum coverage period of 39 weeks. Someone invoking paid family leave only has 6 weeks of benefits per year.
The money collected from SDI is not subject to taxation.
If a beneficiary is able to be employed part-time, he or she can still receive the SDI benefit. In the event the quantity of money the beneficiary earns and receives from SDI is less than their weekly wages from the period just before their disability began, they can continue to get the full SDI benefit. If the beneficiary's part-time income plus SDI benefit are more than the pre-disability wages, the SDI benefit will be adjusted accordingly.
An employee's benefits may be reduced for reasons outside of part-time employment. SDI counts certain kinds of income as if they are wages. They include:
- Military pay
- Workers' compensation payments
- Pay for holidays
- Pay for sick leave
- Social Security Disability Insurance (SSDI)
SDI doesn't include vacation pay.
If the beneficiary receives a fractional benefit, they can continue receiving it until the entirety of the benefit is paid even if it's longer than 52 weeks.
How Other Benefits Affect Your SDI Benefit
When an employee receives other benefits, they can ask the EDD to combine the SDI benefit with their sick pay or paid time off. If the employer agrees, it can pay the employee just enough out of the sick time or paid time off to combine it with SDI. This can create an income of the same amount the employee was receiving prior to becoming disabled.
When applying for SDI, the employee selects "Integrated Benefits" on the form for the type of income they are receiving from their employer. An employee is allowed to receive sick pay or paid time off for the first seven days of their disability. SDI starts paying on the 8th day. Receiving paid vacation does not affect the SDI payment for the employee.
If an employee applies and is approved for SSDI, the state may exercise the option to reduce the amount of the disability benefits from the SDI payment.
Paid Family Leave (PFL)
Paid Family Leave is a part of the SDI program and there aren't any separate premiums to pay for the benefit. If an employee is eligible for SDI, then they are also eligible for PFL.
PFL comes with a few special rules including a different claim form. If someone takes PFL to take care of a sick family member, their doctor has to certify their illness. The caregiver can only get six weeks of PFL a year, and it doesn't protect someone's job. Family Medical Leave Act may need to be invoked in order to protect a job position.
SDI considers a pregnancy as a condition that might keep someone from working for a period of time. The benefit period for pregnancy is four weeks before the due date to six weeks after delivering. If there's an issue with recovery or pregnancy that keeps her from working past the benefit period, the physician needs to state so on the form. After the delivery, she does not need to apply for a separate PFL claim to have time to bond with her child. PFL sends a form to fill out after the SDI benefit ends. She will get the same benefits as she did during the pregnancy.
How Do I Contact the SDI Program?
An employee has to contact the Employment Development Department (EDD) of California about SDI benefits. Non-English speakers can ask for a person who speaks their language.
What Are the Medical Eligibility Requirements for SDI?
Medical eligibility is defined as any illness or injury that's either mental or physical that prevents an individual from doing their usual job. It also covers disabilities that come about as a result of pregnancy, childbirth, elective surgery, or a medical condition.
In the event the individual is taking PFL to care for a sick relative, the relative needs to have a physical or mental condition that requires treatment, hospitalization, or hospice care.
How Do I Apply for SDI?
Applications can be found in medical providers' offices, the SDI offices, or the SDI website. Application and processing are done by mail. If the EDD approves the application, the individual gets a notice of eligibility in the mail. The notice includes an estimate of the weekly benefit.
Employees Eligible for SDI
Individuals who have received a minimum of $300 in wages during the base period are eligible for payments from SDI. They must miss eight consecutive days of work to qualify for payments. They must also be under the care of a physician who can certify that the individual is unable to work.
Ways Employees Can Be Disqualified From SDI
There are a few ways an employee can get themselves disqualified from SDI. They include:
- Incarcerated after being convicted of a crime
- Unable to work as result of a felony they committed
- Receiving unemployment benefits
- Receiving sick pay that is equivalent to their regular salary or wages
- Collecting PFL benefits
- Collecting worker's compensation payments that are higher than what the employee could receive on SDI
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