 | | | California State Disability Insurance: Frequently Asked Questions | | | | | | | | |
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 | |  | | “How do my assets affect my eligibility?” | |  | |  |
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| | | | “I'm on SSDI. Can I be eligible for SDI too?” | | | | |
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1) What is the State Disability Insurance (SDI) program? |
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| The State of California administers the State Disability Insurance program, commonly referred to as SDI. It is a public disability insurance program that pays a benefit every other week.
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2) Who Pays for SDI? |
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Covered employees pay SDI premiums through payroll taxes. Self-employed people may participate by enrolling in elective coverage and pay premiums based on their profits from the previous year. |
3) By what other names is the SDI program known? |
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The acronym used by the State Disability Insurance program is "SDI", although others may use "DI". State Disability may also be referred to as "short term disability", which can cause misunderstandings. Short Term Disability is private disability insurance that can be offered from an employer or purchased by individuals. |
4) Who is covered by SDI? |
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Most California employees are covered by SDI. Groups of employees that are not covered include:
- Interstate Railroad workers
- Some domestic workers
- Most government employees
- Some non-profit employees
- Those who claim a religious exemption
People who are self-employed or have their own business can get elective coverage.
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5) What is Paid Family Leave? |
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Paid Family Leave (PFL) is part of the SDI program. It replaces income you lose when you miss work to care for a sick relative or bond with a new child. Although there's a different form for making a claim , the benefit is calculated the same way as SDI is. You can have up to six weeks of PFL per year. |
6) Does SDI come with any health coverage? |
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No. SDI only provides wage replacement income.
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7) How is the SDI benefit calculated? |
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The SDI program generally pays 55% of the wages you earned before your disability. They determine your wages by looking 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 determine your benefit.
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8) How is a base period determined? |
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The base periods are determined as follows:
Claims beginning in the months of January, February, or March of 2008:
The base period is the 12 months from October 1, 2006 to September 30, 2007. Claims beginning in the months of April, May, or June of 2008:
The base period is the 12 months from January 1, 2007 to December 31, 2007.
Claims beginning in the months of July, August, or September of 2008:
The base period is the 12 months from April 1, 2007 to March 31, 2008.
Claims beginning in the months of October, November, or December of 2008:
The base period is the 12 months from July 1, 2007 to June 30, 2008.
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9) How long does the SDI benefit last? |
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Your benefit period depends on your medical provider's statement of how long your disability is expected to last. Your medical provider can extend this period up to the program maximum, which is generally 52 weeks (39 weeks for elective coverage). If you return to work part time or have other income during your benefit period, you can get a partial benefit for longer than 52 weeks.
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10) What are the medical eligibility requirements for SDI? |
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Medical eligibility is for any illness or injury, either physical or mental, that prevents an individual from doing his or her usual or customary work. This definition also includes disabilities resulting from elective surgery, pregnancy, childbirth, or a related medical condition.
If you are getting Paid Family Leave for caring for a sick relative, the relative has to have a mental or physical condition that requires hospitalization, hospice care, or treatment in a residential medical facility.
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12) How do I apply for SDI? |
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For, Paid Family Leave, call 1-877-BE-THERE to order a form.
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13) How soon after applying will I be eligible for benefits from SDI? |
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There is a seven day waiting period for all disabilities before benefits are paid. Benefits are issued from the eighth day forward. SDI normally processes applications within 14 days from the date of receipt.
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14) I used to work for a California employer. What happens if I became disabled after recently enrolling as a self-employed individual and just started paying into elective coverage? |
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There is usually a minimum of six months from the effective date of elective coverage before your eligibility can be based on your contributions. However, if you worked as an employee in California (and were paying into State Disability Insurance) prior to enrolling in elective coverage, you may have wages in your base period from that may provide you with a valid claim. |
15) What other benefit programs are available to me and how will they work with SDI? |
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If you are eligible for other private and public benefit programs--such as private Short Term Disability, private Long Term Disability, Social Security Disability Insurance, Supplemental Security Income --these benefit programs usually consider SDI when calculating their benefit. The availability of other benefit programs depends on your work history, what an employer provides, and any benefits that you may have purchased. Each of these public and private benefits programs will have their own rules for enrollment, medical eligibility and any benefit reduction for SDI. You generally can't get SDI and Workers' Compensation at the same time, except when you are waiting for your Workers' Compensation claim to be decided. You can't get Unemployment Insurance and SDI benefits at the same time.
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16) What is the difference between State Disability Insurance (SDI) and Social Security disability programs? |
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The SDI program is sponsored by California and covers a wide range of disabilities lasting more than seven days. Their medical determination covers individuals that are unable to work in their usual or customary work and who are partially or totally disabled. It also covers Paid Family Leave for those who are caring for a sick relative or bonding with a new child.
Social Security’s disability programs require that the disability be a total disability, which will last for a continuous period of at least 12 months or can be expected to result in death. Social Security requires that a 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--engage in any other kind of work that exists in the national economy.
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17) | | | | “I'm on SSDI. Can I be eligible for SDI too?” | | | | |
Can I qualify for the State Disability Insurance (SDI) program while I am eligible for either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)? |
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18) How do I stay enrolled/eligible in the SDI program? How often do I have to reapply? |
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To continue to be eligible for the duration stated by your medical provider, you will need to complete the “Disability Claim Continuing Eligibility Certification” questionnaire that is mailed quarterly. Also see " How long does the SDI benefit last? ". |
19) Are there rules for immigrants to qualify for SDI? |
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SDI does not have a proof of citizenship or immigration status requirement at the time of application.
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20) Will SDI provide me with income if I am currently still working and need to reduce my work hours because of my disability? |
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Yes. You may be eligible for a partial or full benefit if you are working less than your regular hours.
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21) Is the SDI benefit taxable? |
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No. Benefits are not taxable, unless your SDI is in place of Unemployment Insurance. In this case, your SDI benefit is taxable.
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22) Can I receive both Unemployment Insurance and SDI benefits? |
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No. You cannot receive Unemployment Insurance and SDI benefits simultaneously. You should consider Unemployment Insurance if you are now able to work and looking for work. You should apply for SDI if you are unable to work due to a disability. |
23) What happens when I work while receiving benefits from the SDI program? |
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Your SDI benefit amount depends on how much you make with the combination of your new wages and SDI benefit. If that amount is lower than your pre-disability wages, you'll continue to receive the full SDI benefit. If that amount is higher than your pre-disability wages, your SDI benefit will be reduced accordingly.
If there is a reduction in your SDI payment, your benefit period may go beyond the 52 week maximum (39 weeks for elective coverage).
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24) When should I file my claim? |
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You should file your application in a timely manner, no earlier than the 9th and no later than the 49th day after the date your claim states your disability began. If you are beyond the 49th day, include a letter explaining why you couldn't file your claim in time.
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25) Does SDI cover pregnancy? |
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Yes. For a pregnancy without complications, the benefit period is generally from 4 weeks before your due date to 6 weeks after your delivery. If your pregnancy prevents you from working before or after that period, your doctor has to indicate why on the claim form.
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26) Are SDI programs available and the same in the rest of the country? |
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No. There are only five states that provide state disability programs, California, Hawaii, New Jersey, New York, Rhode Island, and the Commonwealth of Puerto Rico. Each state or Commonwealth governs how its program is structured.
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