EDD Disability

What Is EDD Disability?

EDD disability refers to a disability insurance plan administered by the state of California’s Employment Development Department (EDD). Often simply called “Disability Insurance,” these plans are designed to offer partial wage replacement to California residents who find themselves unable to work due to a current disability.

These plans are managed by the California State Disability Insurance (SDI) program, which is also the name of the department that administers these plans.

For state-issued plan purposes, California defines a disability as a physical or mental condition that stops an employee from performing typical job duties. This can be caused by injury, illness, surgery (including elective and cosmetic procedures), pregnancy, or childbirth. In this way, disability insurance can act as a sort of paid maternity leave.

Most employees cannot opt out of paying into the EDD disability program. The only exceptions are an employer that applies for approval of a voluntary plan to replace SDI coverage or a member of a religious sect, denomination, or organization in which basic tenets require full dependence on prayer for healing.

It’s important to note that EDD disability plans don’t offer job protection. While this benefit may be obtained through other programs (such as the Family and Medical Leave Act), EDD disability insurance plans provide monetary compensation only.

What Is State Disability Insurance (SDI)?

State Disability Insurance (SDI) is a deduction from employee wages that provides partial wage replacement and has several requirements and limitations:

• Applies when the employee can’t work due to an injury, illness, or condition that prevents them from doing their job
• Covers those who need to care for a new child, have a loved one being deployed overseas, or need to care for a sick or injured loved one
• Typically pays 60% to 70% of wages from 5 to 18 months before the claim
• Lasts up to 52 weeks

Disability Insurance

Disability insurance is the part of SDI that provides short-term partial wage replacement.

To qualify to receive EDD and disability payments, there are a number of requirements:

• The claim must be filed between day 9 and day 49 of disability onset.
• The claim doesn’t begin until a practitioner certifies the disability and a loss of wages occurs.
• If an employee files late, a claims analyst will review the case to determine eligibility.

Paid Family Leave (PFL)

California’s state disability insurance program also provides for employees who don’t have a disability but need to take time off of work to care for a loved one. This includes:

• Immediate family
• Registered domestic partner
• Members of their family of origin
• In-laws
• Grandparents
• Grandchildren

An employee may also qualify for PFL if a loved one in the military is being deployed to another country or if they need time off to bond with a child who has just entered the family through birth or other legal means.

Payments will vary based on how much an employee made in their base period.

Who Can Qualify for the EDD Disability Program?

To qualify for the EDD disability program, an employee must suffer from a non-work-related condition that makes them unable to work for at least eight days, and they must prove that they are losing wages because of it.

There are some additional eligibility requirements outlined by the state of California:

• Be employed or actively job-searching at the time of disability
• Have earned at least $300 and had SDI deductions taken out of the employee’s check during a base period (5 to 18 months before payments begin)
• Be actively receiving treatment from a licensed practitioner or accredited religious practitioner within the first eight days of the disability
• Not be a school employee on break and/or receiving full wages unless the employee normally works a job for extra income during those breaks

Note that employees must continue receiving treatment for as long as they receive disability insurance payments to stay eligible.

Those entering a drug rehab facility may be eligible to receive SDI if the treatment has been recommended by a medical or religious practitioner and isn’t the result of a criminal violation.

Often, an employee doesn’t have to be out of work to qualify for SDI payments. Those who must work reduced hours due to their disability—and have lost wages as a result—should also file a claim to see if they qualify. However, the employee still has to meet all other requirements.

Citizenship and immigration status don’t impact an employee’s ability to qualify for SDI payments. Additionally, the employee’s state of residence doesn’t affect eligibility as long as they work for a California employer and pay into the CASDI program.

SDI for State Employees

Note that SDI works a little differently for state employees and covers only those in bargaining units 1, 3, 4, 11, 14, 15, 17, 20, and 21. Employees in other bargaining units may be eligible for non-industrial disability insurance (NDI), a program specifically reserved for state employees who meet certain coverage requirements.

While nearly all employees pay into this system and qualify for disability, certain workers do not. This includes:

• Some domestic workers
• Independent contractors
• Employees working for a political campaign
• Students who work for their schools

Can Employees Who Are Injured on the Job Collect SDI from the EDD Program?

In general, employees who are injured on the job can’t collect from California’s EDD disability insurance program. This program is limited to those with non-work-related injuries, illnesses, and conditions that make an employee unable to work.

Those who have been injured at work should notify their employer right away and inquire about the process of filing a workers’ compensation insurance claim. Employers should note that prolonging the workers’ compensation process through disputes and appeals may result in an employee being able to file a claim for SDI to make up for lost wages during the dispute process.

If the claim is ultimately approved, the employee will likely have to repay any overpayments resulting from the disputes. Therefore, employees must disclose all necessary information about any active claims when filing a claim with either the SDI office or a workers’ compensation insurer.

Additionally, workers’ compensation benefits that add up to less than what the employee would be paid on SDI can also make the employee eligible for SDI. In these cases, SDI payments will usually be reduced to simply “fill the gap” and avoid instances of payment overlap.

How Does Short-Term Disability Insurance Work with SDI Coverage Through the EDD Program?

Unlike filing a workers’ compensation claim, employees receiving short-term disability insurance payments can generally receive SDI coverage through California’s EDD program. However, this usually only happens with employers that have integrated their in-house benefits with the EDD program.

This process, also known as “supplementation,” is designed to allow an employee to completely replace their salary while out on disability. Employers should contact the EDD to find out how much an employee is being paid through SDI as employees are not allowed to receive more than 100% of their wages through benefits integration.

However, employers should know that the state of California does not mandate exactly how much to pay employees. Additionally, there is no formal approval process for wage integration.

To avoid delays and make the claims process easier for employees, employers must request to be added to California’s employer integration list. Employees should also authorize the EDD program to share benefit payment information with their employer when filing an EDD disability application.