How to File for Disability in California

Meeting SDI Eligibility Requirements

Have a qualifying disability. The SDI program defines a disability as any mental or physical condition that keeps you from working. If you’re unemployed, you may still qualify for SDI if your disability kept you from looking for work for at least a week. Nearly any medical condition can be an SDI disability. For example, you may be eligible for SDI if you are pregnant or recently gave birth. Being in treatment for alcohol or drug addiction also may qualify you for SDI benefits.

Verify your employer was covered. While most California employees can receive SDI benefits as long as they meet all the other requirements, some types of employment do not. For example, athletes, independent contractors, or students employed through work-study programs generally are not eligible. To be eligible for SDI either you or your employer must have paid into the program. Some employers voluntarily opt out of SDI and offer their own comparable benefits instead. If you’re not sure, you should check with your employer before you spend time and effort applying for benefits. You must have been working for covered employers in California for a total of at least 18 months to qualify for benefits.

Confirm you’re not also receiving Unemployment Insurance benefits. Although you can receive SDI benefits if you’re unemployed, California law does not allow anyone to claim or receive both SDI and UI benefits at the same time.

Show sufficient base period earnings. To determine whether you’re eligible for SDI benefits, and how much you’ll receive, the EDD looks at your income during the year-long period beginning between 15 and 17 months before the date of your application. The EDD will divide your 12-month base period into three-month quarters. To be eligible for SDI you must have earned at least $300 during one of those quarters. The quarter in which you made the most money is the quarter the EDD will use to calculate your benefits. If you were unemployed during any of those quarters, the EDD will disregard that quarter and start your base period a quarter earlier. For each unemployed quarter, the base period continues to start earlier until it covers a period in which you were employed. For example, suppose you file your application in April. Your base period would be the 12-month period ending December 31 of the previous year. Last year would then be divided into three-month quarters, and the quarter in which you earned the most money would determine your benefits. Continuing the example, assume that from January through April of last year, you worked full time and made $1,100 a month. In May you were laid off, but found part time work in June making $500 a month. You continued that job until October, when you found more full-time work earning $1,500 a month. Since you made the most money in the final quarter of your base period, that would be the amount the EDD would use to calculate the amount of benefits you are eligible for each week. The total amount you earned during your base period also determines how long you’ll receive benefits and how much you’ll be paid each week.

Applying for SDI Benefits

Gather necessary documents and information. Whether you’re applying online or through the mail, you’ll need to have basic documents proving your identity as well as information about your disability and your most recent employment. Identity information includes your name, date of birth, phone number and address. You also will need to provide your social security number and your California driver’s license or state identification card. Employment information includes the business name, telephone number and address of your most recent employer, the last day you worked your regular duties and hours, and wages you’ve received or expect to receive from vacation or other leave. If you worked for a period of time on modified duty to accommodate your disability, you should provide those dates when you submit your claim. If you are receiving workers’ compensation or have filed a workers’ compensation claim, you should also include that information on your claim form. If you are receiving or have received inpatient treatment at an alcohol or drug abuse treatment facility, you should provide the name, address and telephone number of that facility on your claim form.

Create an SDI online account or order a claim form. The EDD gives you the option of applying online or ordering forms and sending them back in through the mail. To apply online, visit the EDD SDI website and enter your identity information to create a new account. If you want to apply through the mail, you can order forms online or by calling 1-800-480-3287. If you order forms online, you may not receive them for two to four weeks. You can also get a paper claim form from your doctor, from your employer, or by visiting your nearest SDI office.

Log on and file a new claim or fill out claim forms. After you’ve either set up an online account or received paper claim forms, you can use the information and documents you’ve gathered to start the application process by filling out Part A of the claim form.

Ask your doctor to complete the doctor’s certificate. Part B of your claim form is a doctor’s certificate. This should be completed by the doctor or other health care provider who is treating you for the disability you’re claiming entitles you to benefits. Your doctor must provide basic details about your diagnosis, disability and treatment, as well as licensing and contact information. Health care providers such as physicians, dentists, chiropractors, surgeons, psychologists and other medical professionals must use the physician/practitioner’s certificate found in Part B of your claim form. If your doctor is registered with SDI Online, she can submit the doctor’s certificate right after you file your claim, and your claim will be processed faster than if she mails in a hard copy. If you are under the care of an accredited religious practitioner for your disability, you must call 1-800-480-3287 to get a different form, the DE 2502 Practitioner’s Certificate, for that practitioner to fill out and sign.

Mail your application to the EDD office nearest you. If you’ve chosen to fill out paper forms, you complete your application by mailing your claim form along with your doctor’s certificate to your nearest SDI office.

Wait for the EDD to review your claim. Most benefits are issued within two weeks of the EDD’s receipt of the completed claim form and doctor’s certificate. Even if your claim is approved before that time, all claims have a seven-day waiting period during which benefits are not paid. If your claim is approved, you’ll receive a letter with a debit card for you to access your benefits.

Filing an Appeal

Fill out the appeal form you received. If your claim is disqualified, you will receive notification of this along with a form you can fill out if you believe the disqualification was in error. Claims frequently are denied because they were filed too late. Claims must be filed within 49 days of the onset of the disability. Because many Californians aren't aware of this deadline, they don't file for benefits in time. You can have your claim considered if you appeal showing good cause as to why you missed the deadline. For example, if you were in the hospital in a coma for two months, that would probably be considered good cause. To qualify for benefits, you must have been working in California for an employer who contributed to the state program for at least 18 months. People with shorter work histories in the state also will be denied benefits, but would be unlikely to prevail on appeal. Many denials also are based on a lack of medical documentation for the disability alleged. If you didn't submit much medical information when you filed your claim, consider getting additional records or more thorough medical history when you file your appeal. Explain in detail why you think you are qualified to receive benefits. Attach any additional medical or employment records or any other documents that back up your claim.

Mail the form and any additional documentation back. You must file your appeal within 20 days of the date your disqualification notice was mailed. If you lose the form itself, you can print the form from the EDD's website, or send in a detailed letter to the same office that processed your claim and issued the disqualification. Sign and date the letter, and include your printed name, address and Social Security number.

Wait for the EDD to review your appeal. If you sent in additional information that renders you eligible, you will receive SDI benefits. Otherwise, you'll receive a notice that your appeal has been forwarded to the Office of Appeals.

Review your hearing notice from the Office of Appeals. If the EDD's Office of Appeals receives your appeal, you'll receive a hearing notice from that office that schedules a hearing for your appeal. If you aren't able to attend your hearing on the date scheduled, you must call the office at the number on the notice as soon as possible to reschedule. If you don't show up for your hearing, your appeal will be dismissed.

Attend your appeal hearing. Appeals are slightly less formal proceedings than a court hearing, and you don't necessarily need an attorney. However, you might want to speak to an attorney with experience in public benefits if your case is complex or you find the procedure confusing. An Administrative Law Judge will hear your appeal. The ALJ is an independent third party who will listen to both sides of the case and decide whether benefits should be awarded. All testimony is under oath. Generally, the only testimony will be from you and an SDI representative. The ALJ will mail a decision to all parties. The decision of the ALJ is final.