The People's Guide

36th Edition 2015

Issue link:

Contents of this Issue


Page 16 of 71

17 The People's Guide 2015 If You Are Disabled You may not be eligible for SDI benefits if you: • Are not suffering a loss of wages: • Are claiming or receiving Unemploy- ment Insurance. • Became disabled while committing a crime resulting in a felony conviction. • Are receiving workers'compensation benefits at a weekly rate equal to or greater than the SDI rate. • Are in jail or prison because you were convicted of a crime. • Are a resident in an alcoholic recov- ery home or drug-free home, unless it is licensed and certified by the state • Fail to submit to an independent medical examination when requested to do so. If you do not have sufficient base period wages and you remain disabled, you may be able to establish a valid claim by using a later beginning date. If you do not have enough base period wages and you were actively seeking work for 60 days or more in any quarter of the base period, you may be able to substitute wages paid in prior quarters. Additionally, you may be entitled to substitute wages paid in prior quarters either to make your claim valid or to increase your benefit amount if during your base period you were in the military service, received workers' compensation benefits, or did not work because of a labor dispute. You have the right to appeal, and should appeal any disqualification, overpay- ment, or penalty that you do not agree with. Specific instructions on how to ap- peal will be provided on the state forms you receive. If you file an appeal and you remain disabled, you must continue to complete and return continued claim certifications. For residents in a state-approved alco- holic recovery home or drug-free resi- dential facility, the maximum payable period is 90 days. (However, disabilities related to or caused by acute or chronic alcoholism or drug abuse which are being medically treated do not have this limitation). 1. State Disability Insurance If you cannot work for a temporary period because of an illness, injury, or pregnancy, you may be able to get state disability insurance benefits (SDI). These benefits range from $50 to $1075.00 per week depending on your earnings in a prior quarter, and can last up to one year (39 weeks for employers and self-employed people who elected SDI coverage). You must be unable to do your regular or customary work for at least eight consecutive days. You must have lost wages because of your disability or, if unemployed, have been actively looking for work. You must have earned at least $300 from which SDI deductions were withheld during a previous period. You must be under the care and treatment of a doctor during the first eight days of your disability. (The beginning date of a claim can be adjusted to meet this requirement.) You must remain under care and treatment to continue receiving benefits. You must apply within 49 days of the date you became disabled or you may lose benefits. You do not need to apply in person to receive benefits. If your disability prevents you from completing the claim form, or you are filing for benefits on behalf of a disabled claimant, call (800) 480-3287 for required forms and instructions. You must also ask your doctor to com- plete and sign the "Physician Practi- tioner's Certificate." If your doctor will mail your completed certificate to EDD provide him/her with an envelope ad- dressed to the SDI office listed below. Mail your claim no earlier than 9 days - but no later than 49 days -after the first day you became disabled. Mail the completed, signed "Claim Statement of Employee" together with the completed, signed "Physician Practiioner's Certifi- cate" to: • State Disability Insurance P.O. Box 10402 Van Nuys, CA 91410-0402 OR • State Disability Insurance P. O. Box 513096 Los Angeles, CA 90051-1096 • File online: Worker's Rights When your claim is received, the SDI office will notify you of your weekly benefit amount and request any ad- ditional information needed to deter- mine your eligibility. If you meet all requirements,EDD will provide you with a debit card for your disability payments. The first seven days of your claim is a waiting period for which no benefits are paid. If you are eligible for further benefits, either additional payments will be sent automatically or a continued claim certi- fication form for the next two weeks will be sent. You must report income you receive, even though sometimes it does not reduce your SDI payments. Coordination with Worker's Comp If you also have a worker comp. claim and the insurance carrier delays or refuses payments, SDI may pay you benefits while your case is pending. However, SDI will pay benefits only for the period you are disabled and will file a lien to recover benefits paid. SDI and Workers' Compensation are two separate programs. You cannot legally be paid full benefits from both programs for the same period. However, if your workers' comp benefit rate is less than your SDI rate, SDI may pay you the difference between the two rates. Long-term or Permanent Disability: If you expect your disability to be long- term or permanent, apply for SSDI from Social Security well before your year of SDI is over. (see page 23 Social Security).

Articles in this issue

Links on this page

Archives of this issue

view archives of The People's Guide - 36th Edition 2015