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Disability Benefits in California

By: Janet Ambrose
Facing a disability, temporary or otherwise, is not something that most people put much thought into. However, illness is often unexpected and accidents can occur in the blink of an eye. If this results in the inability to continue working, a person will have a loss of income to contend with. In other cases, pregnancy or giving birth to a child can take a person away from their work for a short length of time. Although this is different from a debilitating injury or illness, it still results in a lack of a paycheck to pay bills and other necessities. Most residents of California can participate in CA State Disability Insurance Programs that are administered by the Employment Development Department (EDD). In addition, residents of California who are also receiving federal Supplemental Security Income (SSI) are also able to combine it with a California supplement.

Funding for CA State Disability Insurance comes from employee payroll deductions. It consists of both Disability Insurance (DI) and Paid Family Leave (PFL). While both programs are meant to replace a portion of the insured wages in the event of a short term disability, they vary in what they cover. The DI program provides short term benefits when the insured is suffering a non-work related injury or illness. People on the CA Disability State Plan are entitled to benefits for up to 52 weeks, with their benefits being roughly 55 percent of their normal pay. The PFL program provides benefits when the insured must leave work to care for a family member who is seriously ill, such as a spouse, child or parent.

People who meet the EDD disability requirements for California disability benefits are eligible for the DI program. Additionally, anyone who has CA State Disability Insurance coverage is also covered by the PFL program. The first eligibility requirement is that the person filing must meet the California Unemployment Insurance Code definition for disability. This defines a disability as having an illness or injury that is either mental or physical in nature and that hinders the person's ability to perform work that is regular or customary. In addition, he must not be able to work for eight days in a row. People requesting California disability benefits must have been working and had State Disability Insurance deductions withheld over the previous quarter. If unemployed, they must be attempting to find gainful employment at the time of the disability. The person in need of the benefits will have to fill out an insurance claim form no later than 49 days following the disability. This form can be found on the CA EDD website, where it can be filled in, downloaded and mailed or hand delivered to the nearest DI office.

The applicant must be under the care of a physician during the first eight days of the disability and continue under his care while receiving benefits. A medical certification of the disability must be completed by the applicant's doctor, or if pregnant, a midwife or nurse practitioner may also do so. A religious practitioner may sign a Practitioners Certificate in lieu of a medical certificate only if the religious practitioner has been certified by the EDD. An applicant may also be under the care of the accredited religious practitioner. California workers that are not covered by CA State Disability program includes certain domestic and government workers, interstate railroad employees, nonprofit employees and people who claim religious exemption.

Another CA disability plan is the private Voluntary Plan. Although the State Plan is mandatory, it may be replaced with the Voluntary Plan if a majority of a company's employees want it. If an employee prefers the State plan over the Voluntary Plan however, he may elect State coverage instead. The benefits that employees receive from a Voluntary Plan must be equal to the State Plan with the exception of having one benefit that is greater than what the State Plan provides. It must not, however, cost the employee more than the State Plan.

California disability benefits also impact certain federal disability benefits. The federal Supplemental Security Income (SSI) program is meant to help provide financial support to disabled people who have extremely limited income and resources. Californians who are eligible to receive SSI can also receive an additional supplemental payment through a state program called State Supplementary Payment (SSP). Although SSP is a California supplemental program it is not an EDD disability program, and is instead run by the Social Security Administration.

Receiving benefits from CA disability programs is a way to ease the financial burden when dealing with an unexpected short term disability. Employers are required to make these EDD disability programs available to their employees so that they have the opportunity to temporarily receive a portion of their wages if they are unable to work. The 52-week period to receive these benefits is longer than many other states, which is helpful for people who need longer than six months. Employees working in California should learn what benefits are available to them in the event that they are ever needed.

 

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