Learn About Requirements for Disability Insurance Benefits

For those who are eligible For DI Benefits, the state of provides a worker-funded program, which is comprised of partial wage-replacement benefits. You may be eligible for DI benefits if you are unable to work due to a non-work-related injury or illness or pregnancy or post-natal activities that have caused you to lose wages. To meet eligibility for Disability Insurance Benefits , you must be able to satisfy all of the program qualifications. Continue reading this page to learn more about disability insurance eligibility requirements .

Learn About DI Requirements

To meet ’s disability insurance eligibility requirements, you must have been either employed or actively seeking work at the time your disability began. DI eligibility requirements mandate that your disability must have prevented you from continuing your usual work for a minimum of eight consecutive days. In order for you to be eligible for DI benefits, your illness or injury must have caused you to lose wages or if you are unemployed, it must have prevented you from looking for another job. You must also meet minimum earnings and CA State Disability Insurance, or SDI, deductions requirements for the previous base line period.

To learn more about the financial qualifications associated with DI benefits , download our free guide.

Learn About Medical Requirements for DI

To qualify for disability insurance benefits, you must be receiving treatment from a licensed medical practitioner or an accredited religious practitioner for at least the first eight days of your illness or injury. The date in which your claim for disability insurance benefits begins may be adjusted to fulfill this requirement. To continue to qualify for disability insurance benefits, you must remain under medical care.

To be eligible for DI benefits, you must also fill out and submit your claim form (DE 2501) within 49 days of the beginning of your disability. Otherwise, you may lose benefits. Eligibility for Disability Insurance benefits requires that you submit you claim form no sooner than nine days after your disability commences.

Disability insurance eligibility requirements specify that your medical practitioner must complete the medical certification regarding your disability. The certification may be completed by a nurse practitioner if it is within the scope of his or her practice, however, in this case, the physical examination must be performed in collaboration with a physician. If you are claiming DI because you are pregnant, then the medical certification may be completed by a licensed midwife, a nurse practitioner or a nurse-midwife. If your healthcare provider is a religious practitioner, you must fill out Practitioner’s Certificate (DE 2502). In this instance, certification by a religious practitioner is acceptable, only if the practitioner has been accredited by the Employment Development Department. In any of these cases, you may be required to undergo an independent medical examination to determine your eligibility.

To learn more about disability insurance eligibility requirements , download our comprehensive guide.

Who does not meet requirements for DI benefits ?

Even if you are not sure if you are eligible for DI benefits, you may still file an application. If you are found to be ineligible for some or all of the period of time you have claimed, then you will be notified about the time period, and you will be given an explanation of the decision. You may not meet disability insurance eligibility requirements if you are already claiming or receiving Unemployment Insurance (UI) or Paid Family Leave (PFL) benefits, or you are currently receiving workers’ compensation benefits at a weekly rate equal to or more than the than the weekly rate of Disability Insurance. You will not meet ’s disability insurance eligibility requirements if your disability is a result of an injury incurred while you were committing a crime which resulted in a felony conviction. In addition, your claim for DI benefits will be disqualified if you refuse to have an independent medical examination when the EDD requests you to do so.

What happens if you do not qualify for DI benefits?

If the EDD determines that you do not meet the disability insurance eligibility requirements, then you will receive a notice of explanation and an Appeal Form (DE 1000A). If you still believe that you are eligible for DI benefits, then you have the right to appeal the decision within 20 days of the mailing date at the top of the letter. You can file an appeal against your disqualification for DI benefits by completing the appeal form with a detailed explanation of why you think you are eligible. You must include:

• Your DI Claim Identification number.

• Your Social Security Number.

• Your full name and current address.

• Your phone number and/or email address.

• Your signature.

After evaluating your appeal, the EDD will send you a letter explaining the findings. If you have provided further information showing that you are eligible for DI benefits, then the EDD will issue payments. If the EDD cannot issue payments to you, then your appeal form or letter will be forwarded to the Unemployment Insurance Appeals Board.

Download our guide to review more information about DI benefit appeals.