Eligibility and Application

Paying into SDI

Most California employees have to pay into the SDI system and are therefore covered by SDI. If you’re covered, you automatically pay the SDI premium through a payroll tax. This means that every time you get a paycheck, part of it goes to the SDI program. In 2017, this amount is 0.9% of your paycheck. Sometimes this is called your SDI contribution.

Example:

Your paycheck is $1,000 before taxes. Every time you get a paycheck, 0.9% of that goes automatically to SDI. In this case, that’s $10.00. If you get this paycheck every two weeks for a year, you’ll end up paying $260 to SDI every year.

The contributions of the roughly 12 million Californians covered by SDI are set aside in a state fund.

SDI taxes your income up to $110,902 a year. Another way of thinking about this is that the maximum amount that you have to pay to SDI is $998.12 for 2017 (which is 0.9% of $110,902).

Who Is Not Covered By SDI

Most California employees are covered by SDI. Those who are not covered include:

  • Most government workers (Some government workers are covered through a program called Non-industrial Disability Insurance (NDI). Click here for more details about NDI.)
  • Some domestic workers
  • Interstate Railroad employees
  • Some non-profit employees
  • Employees who claim a religious exemption

Types of SDI Plans

There are three different SDI plans.

1. Most California employees are covered by the State plan. This is the basic SDI plan described in this section.

2. Some employers offer Voluntary plans. These are private disability insurance plans that SDI approves of. They have to offer coverage that’s at least as good as the State plan and have at least one feature that the State plan doesn’t have. It cannot be more expensive than the state plan, and it has to be approved by a majority of employees. For more information on Voluntary plans, click here.

3. If you are self-employed or a business owner, you can get Elective Coverage through SDI. Some of the rules are different. For example, Elective Coverage is only for 39 weeks, and premiums are based on a percentage of your profit from the previous year. For more details on Elective Coverage, click here.

Eligibility for the SDI Benefit

SDI should pay you a benefit if you have paid into it and can’t work for one of the following reasons:

  • You have a disability not related to your job. SDI defines disability as “any mental or physical illness or injury which prevents you from performing your regular and customary work”. This is a broader definition than the one used by the federal Social Security Disability Insurance program (SSDI).
  • You are pregnant. Although pregnancy isn’t an “illness or injury”, it is a medical reason for missing work.
  • You need to take Paid Family Leave (PFL). PFL replaces part of your income when you miss work to care for a sick relative or to bond with a new child. It became part of the SDI program in 2004.

You also have to meet the following requirements:

  • If you’re employed, you have to be disabled or miss work for more than 7 days. These days have to be consecutive for your own disability, but not for PFL.
  • If you’re not employed, you have to be actively looking for work.
  • You have to be under the care of a medical provider during the first 8 days of your disability and stay under a medical provider’s care while you’re getting SDI benefits.
  • You have to have $300 in wages during your base period.

On your initial claim, you might be able to adjust your onset date to meet some of these requirements. Once you file your claim, however, your onset date cannot be changed.

DB101 does not cover Pregnancy Disability Leave

This article focuses on SDI for people with disabilities and Paid Family Leave (PFL) for people taking care of a person with a disability. It does not focus on pregnancy-based disability leave. For more information about Pregnancy Disability Leave, contact the EDD.

Filing a Claim

If you meet the requirements, SDI will pay you a benefit. To get this benefit, you file a claim with SDI. This means that you fill out a 4 page form. You fill out two pages giving basic information about yourself and your disability. You then have your medical provider fill out the rest of the form, which asks for a diagnosis and an estimate for when you’ll be able to return to work.

There’s a different form for Paid Family Leave. If you’re caring for a sick relative, a medical provider has to certify the relative’s illness.

You have to file a claim between 9 and 49 days of becoming disabled or missing work. If you file a claim past this limit, you have to include a letter explaining why you couldn’t meet the deadline. If there are no problems with your forms, you’ll usually start receiving a check within two weeks of filing your claim.