Frequently Asked Questions About Disability Insurance In California

Read our frequently asked questions about disability insurance and how to file a claim today.
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Frequently Asked Questions About California Disability Insurance

There are many workers in California who may experience a tragedy in their life. It could result in them being unable to work. The victim of an unforeseen accident may not be able to earn enough income to survive. To avoid this situation, California has a State Disability Insurance (SDI) program designed to provide wage replacement benefits to individuals in California who are not able to work because of injury, illness as well as pregnancy. Over 17 million workers in California are covered by this program.

What Is Defined As A Disability?

According to the state of California, a disability is some type of injury or illness that is either mental or physical. It results in a condition that prevents an individual from engaging in regular and customary duties at their job. This covers a number of things including pregnancy, elective surgery and a variety of other medical conditions. Disability Insurance pays benefits for illness or injuries relating to work under specified circumstances defined by law.

Who Is Eligible For Disability Insurance In California?

A person can collect disability insurance if they are unable to perform their required job duties for a minimum of eight consecutive days. A person should be employed or be actively seeking employments when the disability occurred. An individual must experience a loss of income resulting from the disability. A person must have had a minimum income of $300 from which deductions for California’s disability insurance were taken during the previous employment period. A person seeking disability insurance payments must be receiving treatment and care from a licensed physician or accredited practitioner of a religion. Individuals seeking disability insurance payments must also file a claim within 49 days of the date of becoming disabled. A physician is required to complete a portion of the form that gives medical certification of a disability.

How Are You Covered By Disability Insurance In California?

In California, employees are covered by disability insurance by paying premiums through payroll taxes. Anyone who is self-employed can also be eligible to participate by paying for elective insurance coverage. Their premiums will be based on a self-employed person’s profits from their previous year. Most workers in California are covered by disability insurance through their employer. Some groups of employees are not covered. They are covered by a separate version of disability insurance. This includes interstate railroad workers, certain non-profit workers, some domestic workers as well as most individuals who work in government.

How Long Is The Benefit Period?

This will be determined by the statement given by a medical provider explaining the length of time a person will be disabled. It is possible for a medical provider to extend the time a person receives disability payments to the maximum permitted by law. This is approximately 52 weeks. Should a person go back to their job on a part-time basis or have another source of income, it’s possible their benefit period could last longer than 52 weeks. It is possible in some situations for an individual to remain disabled at the end of their benefit period. When this occurs, a person becomes eligible for long-term disability insurance coverage.

How Do I File A Disability Insurance Claim In California?

The state of California tries to make it as easy as possible to file a claim. The process normally starts when a person’s employer or health care practitioner provides them with the necessary form. This form can also be obtained from California’s Economic Development Department (EDD) website. There is a certain portion of the form a person must complete. Their health care practitioner is responsible for filling out the rest of it. The next step is for the EDD to contact a person’s employer and confirm wages, length of employment and more. The EDD will call or try to contact a person should they have any questions about the information provided. They can answer questions and give a disability insurance explanation if necessary. Should a person qualify for disability benefits, the EDD will send a notice informing them they’re eligible. This notice will also provide information on anticipated benefit amounts and when they should begin receiving benefits. Eligible individuals will receive benefits once every two weeks. It is important people know that any information they provide on their claim form is protected under Health Insurance Portability and Accountability Act (HIPPA). When forms are sent online, the data is encrypted in transit. It is always stored in a way to make certain confidentiality is maintained.

What Is A Typical Claim Amount?

A person in California who is approved to receive disability insurance payments will receive around 55 percent of their usual wages. There is a cap on the amount a person will receive. California will determine the amount a person receives using a base period. In most situations, this is the 12 month earnings period prior to the last complete calendar quarter a person was employed prior to being disabled.

Could I Experience Benefit Reductions?

The amount of benefits a person receives could be reduced for a number of reasons. This includes part-time work, military pay, bonuses, worker’s compensation payments, holiday pay and any other type of income. Depending on a person’s individual situation, a number of these could apply.

What To Do If You Have A Potential Case Related To Disability Insurance Claims

If you believe that you have a case you should contact a San Diego attorney right away. If you would like someone to review your case today, send us an email or call Walker Law at (619) 839-9978 to schedule your free consultation.

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2 Responses

  1. I really appreciate your information that the maximum benefit period for a disability claim is usually around 52 weeks. It’s great that if it is necessary, someone can even maintain the disability coverage after that benefit period. Maybe I should tell my friend to look into a disability claims attorney so that she can have hers extended as well.

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