State Disability Insurance replaces part of your wages when a non-work-related illness or injury stops you working. This guide covers who qualifies, how to apply, and the reasons claims are most often denied.
Who Is Eligible for Short-Term Disability?
An employee is eligible for short-term disability benefits if the individual is unable to work because of a disability and has lost income as a result. In addition, employees are only eligible if they received at least $300 in wages (from which short-term disability taxes were withheld), during the base period. The base period is a one-year period that ends before the last complete calendar quarter before the individual filed a claim. For example, if the employee files a claim in May 2022, the base period is 2021.
How To File a Claim
To collect short-term disability benefits, employees must file a claim with the Employment Development Department (EDD) within seven weeks of becoming unable to work. In addition, the person must submit a medical certificate of disability signed by a physician or practitioner. To make the process easier, having the right information on hand is beneficial. For example, a government-issued ID or driver’s license, social security number, and employer’s business name and address are important components.
Common Reasons for Claim Denials
A claim can be denied even where the disability is genuine. Where the EDD finds discrepancies in a claim, it will deny benefits. Some common reasons for claim denials are:
- Denial on procedural grounds: unverified ID, late claim, or application errors.
- The EDD found that you are able to work full-time.
- EDD refuses to accept the medical certificate from your healthcare provider.
- EDD believes that worker’s compensation should cover your disability.
- EDD found that you are not losing wages because you are receiving other types of income (e.g., a pension).
What To Do if the EDD Denies Your Claim
If a claim is denied you can appeal and set out why you disagree with the determination, and the notice states the deadline. Our note on what to do if you are denied short-term disability covers the route, and the appeal checklist covers what to submit.