An employee in California who is unable to return to work because of a non-work-related injury or illness may be eligible for short-term state disability benefits. If the disability becomes long-term, they may also qualify for federal disability benefits. Navigating both systems can be challenging, yet it’s important to know how to coordinate state and federal benefits correctly in order to avoid costly mistakes and to ensure you receive the full financial support you’re entitled to.
If you need guidance, Disability Advocates Group can help. Contact us for a free initial case evaluation with an experienced disability benefits lawyer. We’ll explain the various state and federal programs, assess your eligibility, and help you pursue the benefits you deserve.
Understanding the Disability Benefit Programs
State and federal government disability benefit programs include the following.
California State Disability Insurance
The California State Disability Insurance (SDI) program, administered by the California Employment Development Department, provides short-term disability benefits to eligible workers who cannot work due to a non-work-related injury, illness, pregnancy, or childbirth. The SDI program receives funding through payroll deductions from California employees. California workers can receive up to 52 weeks of disability benefits.
SDI pays weekly benefits worth between $50 and $1,681, depending on a worker’s wages in the five to 18 months before their claim date.
Social Security Disability Insurance
Social Security Disability Insurance (SSDI), administered by the Social Security Administration, provides disability benefits to individuals who become unable to continue working due to a prolonged or permanent disability. Individuals qualify for SSDI benefits based on their work history, which reflects their contributions to the Social Security system through payroll deductions. An applicant for SSDI must have a sufficient lifetime work history and a recent work history, with the amount of work history required dependent on the applicant’s age at the onset of their disability. The amount of an SSDI monthly benefit depends on an individual’s career earnings and work history.
Individuals who receive SSDI benefits for at least 24 months may also qualify for Medicare.
Supplemental Security Income
The Supplemental Security Income (SSI) program, also administered by the Social Security Administration, provides disability benefit payments to low-income individuals with disabilities. Applicants qualify for SSI if they fall under certain monthly income and countable asset thresholds. The SSI program pays recipients the federal benefit rate, with deductions for countable monthly income earned by the recipient. In some cases, an individual may qualify for both SSDI and SSI and receive these benefits concurrently.
How SDI and SSDI Work Together
Because SDI provides short-term disability benefits and SSDI provides long-term disability benefits, California workers who become disabled due to a non-work injury or illness will generally apply for SDI benefits first. These benefits can provide temporary financial support until a worker’s medical providers confirm that their injury or illness will cause long-term disability (lasting more than a year). A worker may receive SDI benefits while applying for SSDI.
A worker may apply for SDI immediately following the onset of a disability resulting from a non-work-related injury or illness. The worker may then apply for SSDI benefits once their disability lasts for more than a year or after their physician determines that their injury will likely last for more than a year.
An SSDI applicant can also be entitled to back pay for the time between when they became eligible for SSDI benefits and when they actually received them. The California EDD may request reimbursement of any SDI benefits it paid out that overlapped with a recipient’s SSDI back pay. As such, workers who receive SDI and apply for SSDI should report approvals for or changes to disability benefits to the EDD and SSA to avoid overpayments.
Coordinating SDI and SSI
A California worker who becomes disabled from working may apply for SDI benefits. When their disability lasts for more than a year, they will need long-term disability. However, if a worker lacks sufficient work history to qualify for SSDI benefits, they may still be eligible for SSI benefits if they can meet the asset and income thresholds.
How SSDI and SSI Interact
Some workers who become disabled long-term may qualify for concurrent benefits from SSDI and SSI if their SSDI payment falls below the monthly income threshold for SSI eligibility and they can meet the countable asset threshold. SSI benefits can supplement a low SSDI payment. However, because a recipient’s SSI benefits are calculated by their monthly income, any SSDI payments they also receive can affect the amount of SSI benefits they’re entitled to.
California also provides a state supplementary payment to qualifying individuals who receive SSI payments.
Common Challenges
Some of the top challenges and issues that disabled workers may face when coordinating state and federal disability benefits include:
- Possible overlapping payments: Individuals who receive SDI payments while applying for SSDI or SSI may have months of overlapping benefits, especially if they receive back pay from SSDI or SSI. Benefit recipients may have to reimburse certain overlapping payments.
- Confusion between programs: Some workers with long-term disabilities may not realize that SDI provides short-term disability benefits, leaving them without financial assistance once those SDI benefits expire, until they can apply and receive approval for SSDI or SSI.
- Delays in SSDI/SSI approval: Initial denials of SSDI/SSI applications may result in a gap in benefits once SDI benefits expire, although SSDI/SSI back pay may help cover this gap.
- Income and resource limits: Individuals might qualify for concurrent SSDI/SSI benefits if they receive a low SSDI benefit.
Someone who attempts to handle their case alone risks inadvertently claiming overlapping benefits or failing to apply for all available benefits. Alternatively, they might not keep state and federal agencies informed of their current benefit and income status, resulting in overpayments they will need to return.
How a Disability Benefits Attorney Can Help
A disability benefits attorney can help you navigate the various disability benefit programs and obtain maximum financial assistance by:
- Reviewing your work history and financial records to evaluate your eligibility for disability benefits
- Developing a timeline to coordinate the transition between benefit programs
- Accurately completing benefit applications
- Correctly reporting your income, assets, and benefit payments to the EDD and SSA
- Appealing denials of benefit applications or erroneous overpayment notices
Contact Our Firm Today
If you cannot work due to a disability, you may qualify for various financial benefits from the federal and California state governments. Contact Disability Advocates Group today for a free, no-obligation consultation with a disability benefits attorney to learn more about coordinating between your state and federal benefits so that you receive the maximum amount of assistance you’re entitled to under the law.
