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                     State Disability Insurance Benefits

                                                                                                Overview

The California State Disability Insurance (SDI) program provides short-term Disability Insurance (DI) and Paid Family Leave (PFL) wage replacement benefits to eligible workers who need time off work. Employees may be eligible for DI if they are unable to work due to non-work-related illness or injury, pregnancy, or childbirth.

You may be eligible for PFL to:

  • Care for a seriously ill family member.

  • Bond with a new child.

  • Participate in a qualifying event because of a family member’s military deployment to a foreign country.

DI does not provide job protection, only monetary benefits; however, your job may be protected through other federal or state laws such as the Family and Medical Leave Act (FMLA) or the California Family Rights Act (CFRA).

Disability is an illness or injury, either physical or mental, which prevents you from performing your regular and customary work. Disability also includes elective surgery, pregnancy, childbirth, or other related medical conditions.

In order to be eligible for DI benefits, an employee must:

  • Be unable to do their regular or customary work for at least eight days.

  • Have lost wages because of their disability.

  • Be employed or actively looking for work at the time their disability begins.

  • Have earned at least $300 from which State Disability Insurance (SDI) deductions were withheld during their base period.

  • Be under the care and treatment of a licensed physician/practitioner or accredited religious practitioner within the first eight days of their disability. The date their claim begins can be adjusted if it does not meet this requirement. The employee must remain under care and treatment to continue receiving benefits.

  • Complete and submit their Claim for Disability Insurance Benefits (DE 2501) no earlier than nine days after their first day of disability begins but no later than 49 days, or the employee may lose benefits.

  • Have the employee's physician/practitioner complete the medical certification portion of their disability claim.

    • A nurse practitioner may certify to a disability within their scope of practice.

    • A licensed midwife, nurse-midwife, or nurse practitioner may complete the medical certification for disabilities related to normal pregnancy or childbirth.

    • If the employee is under the care of an accredited religious practitioner, they may download and print the Claim for Disability Insurance Benefits-Religious Practitioner’s Certificate (DE 2502) (PDF).

Citizenship and immigration status do not affect eligibility. The employer will be notified that the employee has submitted a DI claim. However, the employee's medical information is confidential and will not be shared with the employer.


School employees are not eligible for DI benefits when receiving full wages or for school break periods unless they normally work another job during the school break for extra income. 


Please note that an independent medical examination to determine the employee's initial or continuing eligibility may be required.

SDI pays employees about 55% of what you used to make at work because the employee:

  • Has a non-work-related illness or injury. These SDI payments may continue for up to a year.

  • Needs to take Paid Family Leave (PFL) to care for a sick relative or to bond with a new child. PFL payments are for up to eight weeks, or

  • Are pregnant. Note: Pregnancy Disability Leave is covered in its own separate section.


Important: If the employee is sick due to COVID-19 or caring for somebody who is sick due to COVID-19, they may qualify for SDI or PFL benefits. 

To get SDI, the employee must have had California SDI taxes (usually 1.1% of your wages) taken out of his or her pay for a certain period of time. If this has been done, SDI will replace some of the income the employee is losing when the employee cannot work for one of the above reasons.

There are three main ways to be covered by SDI:

  • Most California employees (but not all) are automatically covered under the State Plan.

  • Some employers offer private Voluntary Plans instead (these plans must provide coverage at least as good as the SDI State Plan, plus have at least one feature the State Plan doesn't have). 

  • If an individual is self-employed or a business owner, they can pay to get Elective Coverage, which only provides benefits for 39 weeks instead of a full year.

Although work-related disabilities are covered by workers’ compensation laws, DI benefits may also be paid for work-related illness or injuries under certain circumstances.

If you are eligible to receive benefits, payments will be issued in one of two ways:

  • Electronic Payment: If the employee chooses this option, their benefit payments will be deposited to a debit card issued to them.

  • Payment by Mail: If the employee chooses this option, the benefit payments will be issued by EDD check. (Allow 7 to 10 days for delivery by mail.)

                                                                                                            Common FAQ:

Q:  If an employee pays into State Disability Insurance but don’t live in California, are they still eligible for benefits?

A:  Yes, where the employees lives does not affect their eligibility. The employee may still be eligible if their job is based in California and you pay into State Disability Insurance (noted as CASDI on your paystub).

Q:  If an employee quits their job or are laid off and now have a disability, can they file for disability benefits?

A:  You must be working or looking for work at the time your disability begins. 

Q:  If an employee works more than one job. Will they get benefits that cover all their jobs?

A:  Yes. If all of their employers take State Disability Insurance (SDI) out of their paychecks, their Disability Insurance benefits will reflect all jobs. This will be listed as CASDI on the employee's paystubs. Employees must report all employment on their application form when they apply by listing the name, address, telephone number, and last day they worked for each employer.

Q:  Does an employee have to be working at their job for a certain amount of time to be eligible for disability benefits?

A:  No. Eligibility is based on the earnings shown in their base period. Their base period is wages they earned 5 to 18 months before their disability claim begins. The employee must have at least $300 in wages in their base period, and they must have been subject to the SDI tax deduction (withholding).

Q:  Can an employee receive Disability Insurance and Unemployment Insurance benefits at the same time?

A:  No. An employee cannot receive Disability Insurance and Unemployment Insurance benefits at the same time.

The employee cannot certify for disability while also certifying for UI. The employee must choose the program that best applies to them.


Q:  Can an employee opt out of the Disability Insurance program?

A:  No. The State Disability Insurance (SDI) program and contributions are mandatory under the California Unemployment Insurance Code.

There are two exceptions:

  • If the employer or a majority of employees in the company apply for approval of a Voluntary Plan in place of SDI coverage.

  • If the employee adheres to the faith or teaching of a bona fide religious sect, denomination, or organization whose creed, tenets, or principles require dependence on prayer for healing, the employee may request an exemption. If the employee is granted this exemption, they will not be eligible to receive SDI benefits.


Q:  Are government workers eligible for disability benefits?

A:  Some government workers, including school employees, may be eligible for Disability Insurance benefits. To find out, review the collective bargaining contract. If the employee has wages from another employer in their base period, they may be eligible even though their current employer doesn’t participate in State Disability Insurance. 

Q:  Are school employees eligible for Disability Insurance benefits during school breaks?

A:  School employees are not eligible for Disability Insurance benefits if:

  • Full wages were or will be paid to the employee during the contract period when services were performed.

  • A period of disability overlaps with a school break and the employee is not scheduled to work, does not have a history of working during the break, or does not have an additional employer.

  • The disability period extends through the school break period.


However, if the employee is not receiving wages but would have been working for extra income if not disabled (such as teaching summer school classes, tutoring, or other secondary job), then the employee may be eligible for benefits to replace the additional income.

Q:  Will benefits cover an elective or cosmetic surgery?

A:  Yes. Elective and cosmetic surgeries are covered by Disability Insurance. The employee's physician/practitioner must certify that the employee is unable to do your normal or usual job duties because of the surgery.


Q:  Can an employee receive benefits if the employer is going to pay the employee vacation, sick, or holiday pay during their claim?

A:  Vacation Pay: Yes, you can receive Disability Insurance (DI) benefits at the same time.


Sick Pay: An employee cannot receive DI benefits for any period that they also receive sick leave wages that are equal to their full salary. If the employees receive only partial sick leave wages, they may be eligible for full or partial DI benefits. The first seven days of the employee's DI claim is a non-payable waiting period. Any type of wages paid by the employer during the waiting period do not conflict with DI benefits.

 

Other Pay: All other pay, including holiday pay, must be reported to confirm the eligibility. The first seven days of the employee's DI claim is a non-payable waiting period. Any type of wages paid by the employer during the waiting period do not conflict with DI benefits.


Q:  Can an employee get benefits if they are am living in a residential alcohol rehabilitation facility?

A:  The employee may qualify for up to 30 days of Disability Insurance benefits if they are living at an approved residential alcohol rehabilitation facility that a physician/practitioner recommends. An additional 60 days may be paid if the employee remains a resident of the facility and their physician/practitioner continues to certify to them need for continuing residential services.


Q:  Can an employee get Disability Insurance if they go to a drug rehabilitation facility recommended by their physician/practitioner?

A:  An employee may qualify for up to 45 days of Disability Insurance benefits if they live at a physician/practitioner-approved drug-free residential rehabilitation facility. An additional 45 days may be paid if the employee remains a resident of the facility and their physician/practitioner continues to certify to they need for continuing residential services.


Q:  In a criminal case, if a judge tells the individual they won't have to go to jail if they enter a drug or alcohol rehabilitation center, can can that person receive benefits for the time they spend there?

A:  No, an individual cannot receive Disability Insurance benefits if they are in a rehabilitation center because of a criminal violation. These restrictions include federal, state, or other city penal institutions, jails, medical facilities, or public or private hospitals.

If you have any further questions or need additional information about California’s State Disability Insurance program, please contact me for a FREE confidential consultation at (916) 333-653 or Stephen_Fiegel_Esq@comcast.net.


 

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