#Doctor #disability #insurance
Disability Insurance Claim Process
The California State Disability Insurance (SDI) program provides short-term Disability Insurance (DI) benefits to eligible workers. Workers who are unable to work due to their own non-work-related illness or injury, pregnancy or childbirth and are losing wages may be eligible for DI benefits.
1. Review Eligibility Information for DI.
You must be eligible in order to receive DI benefits. Some requirements include being unable to do your regular work for at least eight consecutive days, having lost wages because of your disability, and being either employed or actively looking for work at the time your disability began.
For a complete list of eligibility requirements, review Am I Eligible for Disability Insurance?
If your employer has its own voluntary plan, visit Voluntary Plan. If you are self-employed or an independent contractor and pay into Disability Insurance Elective Coverage (DIEC), visit (DIEC) Eligibility.
2. File a Claim for DI.
To submit a Claim for Disability Insurance (DI) Benefits (DE 2501) using SDI Online, you must first complete a one-time registration in Benefit Programs Online (BPO) to establish an online account. Visit the BPO login page and select Register to get started creating an account now.
BPO registration is available 24 hours a day, 7 days a week.
After you have registered in BPO, select SDI Online which will direct you to the SDI Online Registration Options. Once your registration is complete, log in to BPO and select SDI Online to be directed to your Home page to file your claim.
Important Information About the Start of Your Claim
The day you became unable to work due to your disability is the day or date your disability begins. You will need to include that date when you submit your claim.
You may not change the beginning date of your claim or adjust a base period after establishing a valid claim. If you have any questions about your claim start date, please contact DI at 1-800-480-3287 before filing your claim.
Your claim cannot be submitted any earlier than the ninth day from the date your disability begins and must be submitted no later than 49 days after the first date of your disability or the claim is considered to be a late claim and you may lose benefits.
3. Physician/Practitioner Completes a Medical Certification.
Your physician/practitioner must certify to your disability by completing and submitting the medical certification portion (either through SDI Online or DE 2501 Part B вЂ“ Physician/Practitioner s Certificate of the paper claim form). It is your responsibility to have your physician/practitioner complete and sign the form and submit it to the Employment Development Department (EDD) within 49 days from the date your disability begins or you may lose benefits.
Your claim is not complete until a physician/practitioner completes a medical certification.
4. The EDD Reviews Your Claim.
- Once a properly completed claim form is received, the EDD usually determines whether or not you are eligible to receive DI benefits within 14 days.
- The EDD will send you the Notice of Computation (DE 429D) to inform you of your potential weekly benefit amount. Receiving this notice does NOT confirm that you have been found eligible to receive DI benefits.
5. You May Be Found Eligible or Ineligible for Benefits.
If You are Found Eligible for Benefits
Before you receive benefits, you must first serve an unpaid seven-day waiting period (calendar days). The first payable day is the eighth day of the claim.
Note: Beginning January 1, 2018, Assembly Bill 908 (Chapter 5, Statutes of 2016) increases the DI and Paid Family Leave wage replacement rate to approximately 60 to 70 percent (depending on income) and removes the 7-day waiting period for Paid Family Leave. This applies to claims with a start date of January 1, 2018 or after.
Benefit Payments and the EDD Debit Card SM
For claims beginning on or after January 1, 2018, weekly benefits range from $50 to a maximum of $1,216. To qualify for the maximum weekly benefit amount ($1,216), you must earn at least $26,325.01 in a calendar quarter during the base period. For more information, review Calculating Disability Benefit Payment Amounts.
You will receive benefit payments on an EDD Debit Card issued by Bank of America. Once you receive your debit card, all authorized benefit payments are deposited to your EDD Debit Card account. The same EDD Debit Card is used to issue DI, Paid Family Leave (PFL), and Unemployment Insurance (UI) payments and is valid for three years.
If you have received benefits in the last three years from any of the EDD programs (UI, DI, or PFL), your benefits will be deposited on the previously issued card. For more information, visit The EDD Debit Card page.
If You are Found Ineligible for Benefits
If you are found ineligible, a Notice of Determination (DE 2517) will be mailed to you. An Appeal Form (DE 1000A) will also be mailed with your disqualification notice. You have the right to appeal any decision in writing within 20 days of the mailing date of the disqualification notice. For more information, visit Appeals.
6. You May Need to Certify for Continued Benefits.
If your claim is on automatic payment, after 10 weeks of payment, you will receive a Disability Claim Continuing Eligibility Certification (DE 2593). You must return this form to the EDD to certify that your disability continues. If you do not return the DE 2593, your benefits will stop.
If you are not on automatic payment, you will receive a Claim for Continued Disability Benefits (DE 2500A) every two weeks to certify that your disability continues. If you do not return the DE 2500A, your benefits will stop.
The quickest way to submit the DE 2593 or DE 2500A is through SDI Online.
For more information on how to continue or request to extend your benefits, visit Discontinue, Continue, or Extend Your DI Benefits.
7. Need to Extend or Discontinue Your Benefits?
If you have not recovered
You are eligible to receive benefits until the date your physician/practitioner provides to the EDD. With your final payment you will receive a Physician/Practitioner s Supplementary Certificate (DE 2525XX) by mail.
If you have recovered or returned to work
If you recover or return to work on the date your physician/practitioner provided to the EDD, no further action is required to discontinue your claim.
If you have been approved to go back to work before the physician/practitioner s estimated date of recovery, complete one of the forms below using SDI Online or the paper form:
- The Disability Status section of the Claim for Continued Disability Benefits (DE 2500A)
- The Recovery or Return to Work Certification portion of the Notice of Automatic Payment (DE 2587)
- Question 1 of the Disability Claim Continuing Eligibility Certification (DE 2593)
- Use the Claim Update function on SDI Online
Related DI Claim Information
Disability Insurance (DI) Claim Process, doctor disability insurance.