EDD Disability Laws

The Employment Development Department (“EDD”) is a department of the California state government that operates under the California Labor and Workforce Development Agency. Its purpose is to provide a wide variety of services to California residents, including:

• Unemployment insurance;
• State disability insurance; 
• Paid family leave;
• Nonindustrial disability insurance; and 
• Various employment services (e.g., vocational training). 

In order to help it accomplish its overall mission, the EDD is divided into eight distinct branches that each provide a separate function. For instance, the EDD’s Workforce Services Branch is responsible for overseeing several employment and training programs, which offer services that prepare job seekers to join the workforce.  

For the purposes of this article, however, we will be specifically focusing on the EDD’s Disability Insurance Branch (“DIB”). The DIB is tasked with administering: 

• The State Disability Insurance (“SDI”) program;
• The Nonindustrial Disability Insurance (“NDI”) program; and
• The NDI Family Care Leave program. 

The SDI program mentioned in the above list is further split into two separate benefit programs:

• The Paid Family Leave (“PFL”) program: The PDL provides benefit amounts that are similar to those in the DI program, but are only distributable for up to eight weeks. They can be requested by workers who are eligible and need to either:
  • Bond with a new child;
  • Care for a seriously ill family member; or
  • Take leave due to a family member’s military deployment overseas.
• The Disability Insurance (“DI”) program: Briefly, the DI offers monetary benefits to eligible workers for up to 52 weeks if they contract a non-work-related illness, become pregnant, or get injured.

To learn more about these programs and to find out whether you qualify, you can visit the EDD’s website and click on the EDD branch that corresponds with your issue. If you have questions or need further advice about a specific EDD benefit, then it may be in your best interest to contact an employment law attorney who practices in your area for further assistance. 

How Does the EDD Define disability?

The EDD defines disability as a non-work-related illness or injury that prevents an individual from performing their regular and customary work. This includes both physical and mental disabilities, as well as some work-related injuries or illnesses that satisfy the requirements listed under the EDD’s exceptional circumstances policy.

The EDD also provides disability benefits for individuals who have any of the following conditions:

• Are pregnant;
• Have given birth;
• Need or had elective surgery; and/or
• Various related medical conditions. 

As mentioned, there are some work-related illnesses or injuries that may permit an individual to claim EDD disability benefits. However, the majority of work-related disabilities are typically covered by state workers’ compensation laws. Thus, it is important to review the requirements for both sets of programs to determine which type of benefits program the individual should apply for (e.g., workers’ compensation or EDD disability benefits).

What are the Eligibility Requirements?

As discussed above, only workers who are eligible will receive EDD disability benefits. In order to qualify for EDD disability benefits, an individual must satisfy the following requirements:

• The illness or injury must prevent the individual from doing their regular or customary job tasks for at least eight days; 
• The individual must have lost wages due to their disability;
• The individual must be either employed or actively seeking work at the time their disability starts;
• The individual must have earned at least $300 from which SDI deductions were withheld during their base period;
• The individual must be under the care and treatment of either a licensed physician or accredited religious practitioner within the first eight days of their disability and must remain under that person’s care and treatment to continue receiving EDD disability benefits;
• The individual must complete and submit their claim for EDD disability benefits no earlier than nine days after their first date of disability starts, but also no later than 49 days after it begins; and
• The individual must have their licensed physician or accredited religious practitioner fill out the medical certification portion of their disability claim. It should be noted that there is a separate form that must be used for individuals who are under the care of an accredited religious practitioner.
• • A nurse practitioner may also certify an individual’s disability if it is within the scope of their medical practice. Additionally, if the disability is related to a normal pregnancy or childbirth condition, then any of the following individuals may complete the medical certification:
    • A licensed midwife;
    • A nurse practitioner; or
    • A nurse midwife.

If an individual determines that they meet the requirements provided in the above list, then they can submit their claim for EDD disability benefits. Once this claim is submitted, the individual’s employer will be notified. However, all medical information will remain confidential and will not be shared with the individual’s employer.

What are Some of the Other Types of Coverage?

There are also other types of coverage that a worker may qualify for under the SDI program. Aside from a DI claim, the SDI also offers benefits for the following types of issues:

• Pregnancy: A claim for pregnancy begins the moment a worker has lost wages and a physician or practitioner confirms the individual has a disability that prevents them from doing their job (e.g., in this case pregnancy or a condition related to the pregnancy). The standard disability period for a normal pregnancy is: 
  • Up to four week before the anticipated delivery date; and
  • Up to six weeks (for a normal delivery) or eight weeks (for a Cesarean section) after the actual delivery date.
  • Postpartum benefits are limited to the period in which the worker is unable to perform their regular job duties.
• Paid Family Leave for Bonding: This type of claim provides benefits for eligible workers who need to take time off to bond with a new child that is joining their family either by birth, as a foster care placement, or through adoption. Such benefits may be claimed by new parents of foster or adopted children, fathers, and new mothers either after their DI pregnancy-related claim ends or those who did not previously have a DI pregnancy-related claim.
• Paid Family Leave for Care: This type of claim provides benefits for workers who are eligible and need to take time off work to care for a seriously ill child, parent, grandparent, sibling, spouse, grandchild, parent-in-law, or registered domestic partner. A serious condition must be one that goes beyond the common cold, such as for those that require hospice care or need treatment at an inpatient care facility like a hospital.

In addition to the above claims, the SDI also provides coverage for:

• Paid Family Leave Military Assistance;
• Part-Time Worker or Reduced hours;
• Reduced Wages;
• Workers’ Compensation;
• Voluntary Plan for DI and PFL benefits;
• Self-Employed Disability Insurance Elective Coverage (“DIEC”); and
• SDI and NDI for State Employees.

Finally, information for each of the specific claims in the above list can be found on the EDD’s website under its SDI program. 

Should I Contact a Lawyer?

Depending on your circumstances, it may be difficult to determine whether you are eligible to receive EDD disability benefits. There are many requirements you must meet and not every worker may qualify. Thus, if you need help figuring out whether you qualify or if you have questions about a particular EDD benefit, then you may want to consider consulting a local workers compensation attorney for further advice. 

An experienced workers compensation attorney can tell you if you qualify for certain EDD benefits and/or if there are other benefits that you should already be receiving. Your attorney can also help you with the appeals process if you are denied EDD benefits to which you are entitled. Additionally, your lawyer can explain state law requirements that might be confusing and can answer any questions you may have about EDD benefit programs in general.