Short-Term Disability in California – Who Qualifies?

In California, certain employees who lose wages for more than a week because of a non-work-related injury can qualify for short-term disability (SDI). However, you must have contributed to the state SDI program to be eligible for benefits. You also have to get medical treatment and file a claim for SDI benefits. Receiving benefits from other programs can make you ineligible.

What are short-term disability insurance (SDI) benefits in California?

California is one of the few states that offers an SDI program to employees. The program provides covered employees with a portion of their wages, also called income replacement benefits, as well as paid family leave (PFL). They get these benefits while a disability keeps them from working. Unlike for workers’ compensation benefits, disabilities eligible for SDI cannot be work-related. Some common disabilities that lead to SDI benefits include:

• pregnancy,
• childbirth,
• recovery from an off-work accident,
• elective surgery rehabilitation,
• cancer or some other non-work-related illness, or
• caring for a seriously ill or disabled family member.

The benefit program’s funding comes from employee contributions, which are withheld as payroll deductions as a portion of your state taxes.

The portion of your wages that you are entitled to receive depends on your income. In 2023, if you were making:

• $522.86 per week or less, you would receive 70 percent of your prior wages that you have lost, down to $50 per week if you were making $71.46 or less,
• $611.67 per week or more, you would receive 60 percent of your prior wages that you have lost, up to the weekly benefit cap, and
• between $522.87 and $611.66 per week, you would receive $367 per week.¹

These prior wages are calculated based on what you earned between 5 and 18 months before you became disabled. They are subject to a weekly benefit cap. In 2023, that maximum benefit cap is $1,620.² Your SDI benefits are deductible on your federal taxes. Because they are tax deductible, your SDI benefits may end up being higher than 60 or 70 percent of your take-home pay.

However, these amounts can be reduced if you:

• work part-time,
• have child support or alimony payments to make,
• are earning some of your prior wages on light duty, or
• are receiving other benefits through another program, like unemployment insurance.

Eligible employees generally receive short-term disability benefits every 2 weeks. They can receive them for up to 1 year.

Who qualifies to receive these disability benefits?

In order to receive SDI benefits in California, you need to meet some strict eligibility criteria. Additionally, you must not have a disqualifying factor.

To qualify, you must:

• be unable to work for at least a week because of a disability that is not related to your work or occupation, such as a:
  • pregnancy,
  • sickness, or
  • need to care for a seriously ill family member;
• have lost wages because of your disability,
• either be employed as an employee or be actively looking for a job when your disability begins,
• be under the care of a licensed physician or healthcare practitioner within 8 days of your disability, and continue receiving treatment for as long as you receive SDI benefits,
• have earned at least $300 in your base period that was subject to SDI withholding,
• have your physician complete a medical certification for your SDI application, and
• submit a Claim for Disability Insurance (DI) Benefits.

Your disability claim must be filed:

• no earlier than 9 days after your first day of disability, and
• no later than 49 after your first day of disability.

You will not receive SDI benefits for the first week of your disability. This is known as the SDI waiting period or elimination period. It is to ensure that the disability you are suffering from is sufficiently severe. You can start to receive SDI benefits on the 8th day of your disability.

The “base period” for your required SDI withholding is a 12-month period of time that ends before the preceding quarter. You can see if you have been paying SDI taxes by looking at your pay stub. If there is an itemized listing for “CASDI,” then you have paid into the program.

For example: Susan files for California short-term disability insurance benefits on January 8. The preceding quarter would cover October, November, and December. She must have made at least $300 that was subject to SDI tax in the 12 months ending on September 30.

In some cases, an independent medical examination is also required before benefits will be paid out to California workers.

What can make me ineligible for SDI?

Even if you meet all of the eligibility requirements for SDI benefits in the state of California, you may still be ineligible for these benefits if you:

• are receiving benefits under unemployment insurance,
• are getting paid family leave benefits,
• suffer from a disability that is the result of a criminal activity that leads to a felony conviction,
• are receiving workers’ compensation benefits, unless your workers’ comp is less than what your SDI benefits would be, or
• do not get an independent medical examination if it is requested.

If you are ineligible for SDI, you may still be entitled to unpaid leave. This is often an option under the federal Family and Medical Leave Act (FMLA) or the California Family Rights Act (CFRA).

Additionally, some private insurance companies offer short-term disability (STD) insurance. You may have access to a plan through your employer or directly with an insurer that offers these disability insurance plans. You would make regular premium payments to the insurance company in exchange for disability coverage.

How is this different from Social Security disability insurance (SSDI)?

Eligibility for California’s SDI program is different from the federal Social Security disability insurance (SSDI) in 2 ways. To be eligible for these federal Social Security disability benefits, you need to have:

1. an eligible disability, and
2. sufficient working history.

To receive SSDI benefits, your disability must:

• be a physical or mental impairment that keeps you from doing your job,
• make you unable to do any type of substantial gainful work, and
• last, or be expected to last, for at least 1 year.³

You also need a working history that has accumulated enough work credits. In 2023, you earn 1 work credit by making at least $1,640 in wages or self-employment income. You can earn up to 4 work credits in 1 year.⁴

Your eligibility for SSDI depends on the number of work credits you have and your age when you became disabled. If you are:

• under the age of 24, you need 6 work credits in the 3 years prior to the disability,
• 24 through 30 years old, you need enough credits to cover half the time between your 21st birthday and when the disability began, or
• 31 or older, you need at least 20 credits in the 10 preceding years.⁵

This makes it far more difficult to become eligible for federal SSDI benefits than California state disability insurance benefits.

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