How to Claim Disability Benefits in California

Whether you are filing for federal Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits, or a claim for California State Disability Insurance (SDI),  understanding the specific steps, requirements, and filing time periods is crucial for a successful claim.

At Sackett and Associates Disability Law Firm, we devote our entire legal practice to helping disabled individuals receive the benefits to which they are entitled. We know how essential these benefits are to you and your family, and that you need to get your claim filed properly and completely to avoid unnecessary delays or mistaken denials. We wrote this article to explain how to claim federal disability benefits or state disability benefits in California.

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)

For long-term disability benefits, California residents may qualify for SSDI or SSI, both administered by the Social Security Administration (SSA). Here’s how to apply for these benefits:

Eligibility

SSDI is available to individuals who have worked long enough to accumulate the required amount of work credits and who cannot work because of an injury or illness meeting the SSA’s definition of disability. SSI, on the other hand, is a needs-based program for individuals with limited income and resources, regardless of work history.

Although SSDI and SSI are different programs with different financial eligibility criteria, both programs define a “disability” by using the same terms:

A disability for SSDI and SSI purposes is a physical or mental impairment that last or is expected to last at least 12 months (or result in death) and prevents the person from performing substantial gainful activities (SGAs).

Preparing Your Information

The SSDI and SSI programs require claimants to submit complete documentation of the claimed impairment, including medical records, treating physician examination notes, test results, and lab reports dating back even to before the onset of the disability. For many disabled people, collecting this information is a heavy burden. That’s why we recommend working with an experienced disability law firm with years of practice gathering these documents for clients. Doing the legwork for a client is a great relief to them.

Claimants must also gather their work history information and identify other income or resources. While the SSDI program allows eligible benefits recipients to earn more income and to have many more financial resources as they collect disability, the SSI program does not.

Instead, the SSI program is much more restrictive in its financial eligibility requirements because the program is aimed at helping those with low incomes and very few available resources. You can Both SSDI and SSI claims may be submitted online, by phone, or in person at a local Social Security office. Online applications are encouraged for their convenience and efficiency.

However, before attempting to prepare or file your own SSDI or SSI application, you should take the opportunity to consult with a professional disability lawyer who can help you avoid common errors that self-filers often make. If a necessary document is missing from the claim package, months of unnecessary delays could result. Or, if insufficient medical documentation is submitted, or if the doctor’s conclusions are vague, your claim could be denied.

Initial Claim Review Process

After submitting your application, it will undergo a medical review process. The SSA might request additional information or schedule examinations to assess your condition further. The SSA will notify you of its decision by mail. If approved, the notice will detail your benefit amount and when payments will start. SSDI benefits have a five-month waiting period, while SSI benefits may begin the month after you submit your application, depending on your eligibility date.

Appeal Any Denial, Unfortunately, some valid disability claims are denied initially. Do not accept an initial denial without appealing the decision. Sackett and Associates have extensive experience successfully handling initial claim denials. In fact, more than half of all SSDI and SSI denials are reversed on appeal.

California State Disability Insurance (SDI)

The State of California has its own disability program with very different eligibility criteria than those administered by the federal government. The SDI program is a state-mandated insurance plan providing short-term benefits to eligible workers who suffer a loss of income due to a non-work-related illness, injury, or pregnancy. Here’s how to claim SDI benefits in California:

1. Determining Eligibility: To qualify for SDI benefits, you must have earned at least $300 from which SDI deductions were withheld during a 12-month base period. You also must be unable to perform your regular work for at least eight consecutive days, be employed or actively looking for work at the time your disability begins, be under the care and treatment of a licensed physician/practitioner or accredited religious practitioner within the first eight days of your disability. And you need to complete and mail the SDI claim form within 49 days of the date your disability begins.
2. Getting The Claim Form: The SDI claim form (DE 2501) can be downloaded from the Employment Development Department (EDD) website, by calling the EDD, or by visiting a local EDD office. It’s extremely important to fill out the form accurately. You must provide detailed information requested about your medical condition and employment.
3. Submitting Medical Certification: Along with your claim form, you need to submit medical certification from your treating physician/practitioner detailing the nature of your disability and the length of time you are expected to be unable to work.
4. Submitting Your Claim: You can submit your SDI claim either online through the EDD’s SDI Online system or by mailing the completed form to the EDD. Online submissions are typically processed faster than paper submissions.

After submitting your claim, you will receive a notice of computation indicating your potential weekly benefit amount. If your claim is approved, you will start receiving benefits. The standard benefit period for SDI is up to 52 weeks, depending on your medical certification and available SDI coverage.