How does short term disability work in California? Let’s have a quick pop quiz to see what you really know about how short term disability works:
How does an employee become eligible for SDI?
A. Be paid at least $300 during the “base period” and have SDI deductions taken out of this pay
B. Work for a government agency
C. Nothing must be done. Everyone is eligible for SDI in California
D. None of the above
Which of the following scenarios would qualify for short term disability?
A. Getting a sprained ankle and missing work for a week
B. Having pneumonia and getting a doctor’s note to not come to work for 2 weeks
C. The recovery time from elective or cosmetic surgery that your doctor deems you will be disabled
D. B & C
E. None of the above
F. All of the above
Employees can disqualify themselves from receiving SDI:
The answers are: 1) D. B & C; 2) A; 3) True. How did you do? Are you confident to say that you are eligible for SDI, should you become temporarily disabled? How does short term disability work in California? Let’s explore these answers further.
Did you know that, in other states, short-term disability insurance (STD) is NOT a government benefit? It is actually private insurance through a private insurance company that your employer could choose to implement in its employees’ paid wages or not at all. However, in California, most employees are covered by the State Disability Insurance (SDI) program; it provides partial wage replacement to eligible California employees. This program is funded by deducting from employee payroll deductions, if your employer participates. You should ask the HR manager about your company’s SDI benefits.
If your employer does not participate in it, you may opt-to participate in a voluntary plan that your employer may offer. If you sign up for this plan, it should be during the initial enrollment period; during this period, the insurance company cannot deny you coverage because of a pre-existing condition. If you enroll in this voluntary STD program after the initial enrollment period, the insurance company will review your medical records and may deny you coverage based on a pre-existing condition.
How do You Become Eligible?
Now, if your employer is already participating in the state disability insurance program, how do you become eligible? To receive SDI benefits, you must meet ALL of the requirements below:
- Be unable to do your regular work for at least 8 consecutive days. There will be a 7 day waiting period before you will be able to collect benefit. You’re eligible on the 8th
- Be employed or actively looking for work at the time that the disability occurred
- Have lost wages due to the disability
- Have earned at least $300, from which SDI deductions were taken, during a previous payroll period
- Be under the care and treatment of a licensed doctor or accredited religious practitioner
- Complete and mail in a form within 49 days of the date that you became disabled
- The licensed doctor must have completed the portion of the form that deals with medical certification for disability
How Does Short Term Disability Work if You Don’t Meet One of the Requirements Above?
Unfortunately, if you don’t meet all of the requirements above there is likely nothing that can be done to make you eligible. In addition to not being eligible by not meeting all of the requirements, you may also disqualify yourself by any of the following:
- If you are receiving or claiming unemployment insurance or paid family leave benefits
- Your disability is a result of committing a crime that resulted in felony conviction
- If you are in jail, prison, a recovery home, or any other place as a result of being convicted of a crime
- If you are receiving Worker’s Compensation benefits at a weekly rate equal to or greater than the Disability Insurance rate
- You failed to request independent medical examination
How Does Short Term Disability Work in Real Life Scenarios?
As long as you a full eligible and have properly filed a claim, the Economic Development Department (EDD) will work with you to find out your wages and other necessary information before any payment is made. In California, the SDI program will pay you approximately 55% of your normal wages, up to a certain amount. The weekly maximum amount it capped at $1,129 and is not taxable.
Below are some examples of short-term disabilities that will qualify for SDI benefits:
- Having a condition that renders you disabled for no less than 8 days, including morning sickness from pregnancy
- Recovery from normal labor and delivery
- Recovery time for a car accident
- In California, downtime due to cosmetic surgery qualifies as a short term disability
If you’ve been denied short term disability when you should have been eligible, contact a wrongful termination lawyer to help you through this process.