The “Disability Base Period” is determined by the date on which a claim is filed, as follows:
Regular Base Period:
|
If the claim starts in: |
The base period is the 12 months that ended the previous: |
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January, February, or March |
September 30 |
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April, May, or June |
December 31 |
|
July, August, or September |
March 31 |
|
October, November, or December |
June 30 |
The 12 months that EDD looks at in determining an individual’s Base Period roughly starts 17 months before the individual files a claim, once he or she becomes disabled, and ends about 5 months before he or she becomes disabled.
Unemployment Insurance Code section 2610 provides:
“Disability base period,” with respect to an individual who does not have an unexpired benefit year for unemployment compensation benefits, means for disability benefit periods beginning in October, November, or December, the four calendar quarters ended in the next preceding month of June; the disability base period for disability benefit periods beginning in January, February, or March, shall be the four calendar quarters ended in the next preceding month of September; the disability base period for disability benefit periods beginning in April, May, or June, shall be the four calendar quarters ended in the next preceding month of December; the disability base period for disability benefit periods beginning in July August, or September shall be the four calendar quarters ended with the next preceding month of March.
Unemployment Insurance Code section 2611 provides:
“Disability base period,” with respect to an individual who has an unexpired benefit year for unemployment compensation benefits, shall be:
(a) The same as the disability base period in Section 2610 if the individual has sufficient qualifying earnings in that disability base period.
(b) The same as the base period used to establish the benefit year for unemployment compensation benefits if the individual does not have sufficient qualifying earnings in the disability base period in Section 2610.
Once an individual’s wages for the highest quarter have been determined, the charts below should be consulted to find the weekly benefit amount.
The chart can be accessed by going to http://www.edd.ca.gov/pdf_pub_ctr/de2589.pdf or may be found in the Appendix of this book.
Effective January 1, 1983, the Code was changed to provide a longer period of time for an individual to establish a claim following termination from work if he or she was unemployed and seeking work during the unemployed period.
Unemployment Insurance Code section 2612 was added, which provides:
Notwithstanding any other provision of law, except as provided in subdivision (b) of Section 2611, in determining the benefit rights of any person who cannot establish a valid claim pursuant to Section 2652 because he or she is unemployed during the normal disability base period established pursuant to Section 2610, there shall be excluded from the disability base period those quarters during which the person performed no services in employment for 60 days or more and was actively seeking work. For all quarters so excluded there shall be substituted an equal number of quarters immediately preceding the commencement of the normal disability base period. Benefit rights under this section shall terminate for any disability benefit period that begins when the substitution quarters no longer contain sufficient wages to establish a valid claim under Section 2652.
Inasmuch as this program is a state program, and does not involve the federal government, there is only one disability base period, which differs from unemployment which now has two potential Base Periods, as of January 1, 2012.
In their pamphlet titled, “Disability Insurance Provisions” (DE 2515), the Department provides:
Disability is an illness or injury, either physical or mental, which prevents customary work. Disability includes elective surgery, pregnancy, childbirth, or related medical conditions.
Disability Insurance (DI) is a component of the State Disability Insurance (SDI) program, designed to partially replace wages lost due to a non-work-related disability (see "Other Programs," for job-related disabilities).
SDI contributions are paid by California workers covered by the SDI program. Contribution rates may vary from year to year. For current rates, visit the DI website at www.edd.ca.gov/disability, or contact the Employment Development Department (EDD) Disability Insurance customer service at 1-800‑480-3287 or EDD employment tax customer service at 1-888-745-3886.
DI Plan
• State Plan. The DI state plan is covered in this brochure.
• Voluntary Plan (VP). A private plan, approved by the Director of the EDD, which may be substituted for the State Plan. Voluntary Plans may be established if the employer and majority of employees agree to do so. VP information and filing a claim may be done through your employer. If you are covered by a VP, the provisions of this brochure may not apply to you. Obtain information about your coverage and file a VP claim through your employer.
• Elective Coverage (EC). Employers and self-employed persons, including general partners, may elect coverage. The method of computing benefits for EC participants is not the same as for mandatory rate payers. The cost of participating, which is set annually, can be obtained from your local EDD Employment Tax Customer Service Office.
EC claims are filed in the same manner as State Plan claims; however, there are some differences in eligibility requirements from those listed in this pamphlet.
• For additional information or to apply for coverage, contact EDD DI customer service at 1-800‑480‑3287, EDD employment tax customer service at 1-888-745-3886, or visit our website at www.edd.ca.gov/disability.
How to Claim State Plan Benefits
1. Use SDI Online to securely file for benefits or request a paper claim form.
2. When filing SDI Online, complete all required fields. A receipt number will be generated when your claim is submitted.
If using a paper claim form, complete and sign the "Claim Statement of Employee." Print clearly, and verify your answers are complete and correct as errors delay payments.
3. Have your physician/practitioner complete the "Physician/Practitioner Certification" online or use the paper claim form. If filing online, your physician/practitioner will need your receipt number to complete the "Physician/Practitioner Certification."
Usually a claim cannot begin more than seven days before you were examined by or under the care of a physician/practitioner. Certification may be made by a licensed medical or osteopathic physician and surgeon, nurse practitioner, chiropractor, dentist, podiatrist, optometrist, designated psychologist, or an authorized medical officer of a United States government facility. Certification may also be made by a licensed nurse-midwife or licensed midwife for disabilities related to normal pregnancy or childbirth.
4. File online or submit your paper claim form within 49 days from the first day you were disabled. If your claim is late, you may lose benefits unless your explanation of the delay is accepted as reasonable.
How Benefits Are Paid
• The SDI benefits are paid electronically or by mail. You do not need to appear in person to apply or receive benefits.
• Benefits are paid via the EDD Debit CardSM. The EDD Debit CardSM works like other debit cards, giving you access to funds 24 hours a day, 7 days a week, and can be used everywhere Visa® debit cards are accepted. When your claim is received, you may be contacted through SDI Online, by phone, or by mail for additional information. Most properly completed claims are processed within 14 days.
• The first seven days of your DI claim are a non-payable waiting period.
Benefits are paid as quickly as possible after all information to determine eligibility is received. If you meet all eligibility requirements, benefits will be authorized. If you are eligible for further benefits, you will be authorized additional benefits electronically or sent a "continued claim" certification form for you to complete for the next benefit period. Usually these benefit periods are for two-week intervals. However, DI pays benefits based on daily eligibility within a seven-day calendar week. Partial weeks are paid at a daily rate. This rate is one-seventh of your weekly benefit amount. Please allow 10 days from the date you mail or electronically submit a certification for receipt of payment.
How Your Benefit Rate is Determined
Benefit amounts are based on wages paid during a specific 12-month base period, determined by the date your claim begins. Consider when to start your claim since this may affect your weekly benefit rate, your maximum benefit amount, and the period of your benefit eligibility.
Only base period wages subject to the SDI contributions can be used in computing your benefits. To qualify, you must have earned at least $300 during your base period. The month your claim begins determines which four consecutive quarters are used.
If your claim begins in:
• January, February, or March, your base period is the 12 months ending last September 30. (Example: A claim beginning February 14, 2015, uses a base period of October 1, 2013, through September 30, 2014.)
• April, May, or June, your base period is the 12 months ending last December 31. (Example: A claim beginning June 20, 2015, uses a base period of January 1, 2014, through December 31, 2014.)
• July, August, or September, your base period is the 12 months ending last March 31.
(Example: A claim beginning September 27, 2015, uses a base period of April 1, 2014, through March 31, 2015.)
• October, November, or December, your base period is the 12 months ending last June 30. (Example: A claim beginning November 2, 2015, uses a base period of July 1, 2014, through June 30, 2015.)
Exceptions
: If your claim is determined to be invalid, but you were unemployed and seeking work for 60 days or more in any quarter of your base period, you may be able to substitute wages paid in prior quarters.
You may be entitled to substitute wages paid in prior quarters to either validate your claim or increase your benefit amount, if during your base period you:
• were in the military service.
• received workers’ compensation benefits.
• did not work because of a labor dispute.
If your situation fits any of the above, include a letter and supporting documentation with your claim form.
Wage Continuation.
If your employer continues to pay you wages while you are disabled, your DI benefits may be affected. DI benefits plus wages cannot exceed your regular weekly wage. DI benefits are not affected by vacation pay you may receive.
Maximum Benefits.
The maximum benefit amount is 52 times the weekly rate, but not more than your total base period wages. Exception: For employers and self-employed individuals who elect SDI coverage, the maximum benefit amount is 39 times the weekly rate.
Additionally, benefits are payable only for a limited period to a resident in an alcoholic
recovery home or drug-free residential facility that is both licensed and certified by the state in which the facility is located. However, disabilities related to or caused by acute or chronic alcoholism or drug abuse, being medically treated, do not have this limitation.
Pregnancy.
As with any medical condition, your disability period begins the first day you are unable to do your regular or customary work. DI benefits are based on the period of time your physician/ practitioner certifies you are unable to do your regular or customary work. Do not send in your claim for pregnancy-related DI benefits until the date your physician/practitioner certifies you are disabled.
NOTE: For information on Paid Family Leave (PFL) bonding benefits, see the "Other Programs" section of this brochure.
You May Not be Eligible for Benefits
• If you are receiving Unemployment Insurance or PFL benefits.
• If you are not working or looking for work at the time you become disabled.
• If you are in custody due to conviction of a crime.
• If your full wages are paid.
• If you are receiving workers’ compensation at a weekly rate equal to or greater than the DI rate. If workers’ compensation benefits are paid at a lower rate than your DI rate, you may be paid the difference.
• For the amount of time a claim is late (without good cause).
• If you make a false statement or fail to report a material fact. (A 30 percent penalty may be assessed if benefits are overpaid because you willfully withheld a material fact or made a false statement.)
• If you fail to attend an independent medical examination when requested. (Fees for such examinations are paid by the EDD.)
The California Unemployment Insurance Code provides for penalties consisting of fines, imprisonment, and loss of benefit rights for fraud against the SDI program.
Your Rights.
You are entitled to:
• Know the reason and basis for any decision that affects your benefits.
• Appeal any decision about your eligibility for benefits. (Appeals must be sent to the DI office in writing.)
• Request an appeal hearing before an Administrative Law Judge (ALJ). You may further appeal the ALJ’s decision to the California Unemployment Insurance Appeals Board and the courts.
• Privacy – all claim information will be kept confidential except for the purposes allowed by law.
Your Obligations.
Your responsibilities:
• Complete your claim and other forms correctly, completely, and truthfully.
• Submit your claim and other forms according to time limits on forms. If your claim is submitted late and you believe you have a good reason for being late, you should include a written explanation of the reason(s) with the form.
• Contact DI if you do not understand a question or how to answer it.
• Include your name and Social Security number on letters to DI.
Contact DI
• By e-mail at https://askedd.edd.ca.gov
• By phone at: • English 1-800-480-3287 • Spanish 1-866-658-8846
• By U.S. mail addressed to PO Box 13140, Sacramento, CA 95813-3140. If you do not have a current claim, you may write to any DI office. Note: Do not mail claim forms to this PO Box.
• By TTY (teletypewriter for deaf, hearing-impaired, and speech-impaired persons only) at 1-800-563-2441.
• In person by visiting any of the DI offices listed under "DI Office Locations."
Other Programs
If you are injured on the job or become ill as a result of your occupation, notify your employer.
If you are able and available to work but unemployed, contact the Unemployment Insurance program of the EDD through the website at www.edd.ca.gov/unemployment, or by phone at 1-800-300-5616 (TTY 1-800-815-9387).
If you need help in finding work, job training, retraining, or other services in order to return to work, visit your local America’s Job Center of CaliforniaSM formerly known as One-Stop Career Centers listed at www.servicelocator.org, or in the white pages of your phone directory.
If your disability is permanent or is expected to continue for a year or more, contact the U.S. Social Security Administration at www.ssa.gov, or by phone at 1-800-772-1213 (TTY 1-800-325-0778).
If you take time off work to care for a family member or if you take time off from work to bond with a new child, including newly adopted, newly placed foster children, or those of your registered domestic partner, contact the EDD PFL program at www.edd.ca.gov/disability, or by phone at 1-877-238-4373, or through the California Relay Service at 711.
Note:
A PFL bonding claim form will be sent automatically with the final benefit payment to new mothers receiving DI benefits.
If you are a victim of a crime, contact the California Victim Compensation program at 1-800-777-9229 (TTY 1-800-735-2929). You may also contact your county Victim/Witness Assistance Center.
Questions about spousal or parental support obligations should be directed to the district attorney’s office for the county that issued the court order.
Questions about child support obligations should be directed to the Department of Child Support Services at 1-866-901-3212 (TTY 1-866-399-4096).