Complete California Disability Benefit Program Guide For Claimants

California disability guide for first-time applicants

Californians whose health problems force them to stop working may qualify for both state and federal benefit programs. If you’re thinking about applying for California disability, we’ll explain everything you need to get started below.



Tips to Maximize Your California Disability Payments

The three programs we’ll talk about below are designed to help disabled people make ends meet each month. That said, it’s impossible to qualify for payments from all three at once. Each program has its own unique eligibility requirements you must meet to qualify for benefit payments. So, read through each section and figure out which program fits best for your current situation. That way, if your condition worsens, you can apply for more financial help once you’re eligible for each different program.

Here’s the order in which we recommend most California disability claimants apply for benefits:

  1. California State Disability Insurance (SDI)
  2. Social Security Disability Insurance (SSDI)
  3. Supplemental Security Income (SSI)

We’ll explain why in greater detail under each program section below.

How the State’s California Disability Benefits Program Works

If health problems force you to stop working for at least one week, you likely qualify for California disability benefits. The state manages these payments, and most employees in this state pay into the program through their payroll taxes. Some disabled workers that cannot claim SDI benefits include:

  • Interstate Railroad employees
  • Most government employees (federal, state and municipal levels)
  • Domestic workers (i.e., live-in nannies, housekeepers)
  • Certain non-profit employees
  • Anyone claiming a religious exemption

California SDI Eligibility Requirements, Benefit Amounts & Payment Schedule

You may become eligible for the state’s public California disability benefits program after missing just one week at work. SDI medical eligibility requirements say you must have a mental or physical condition that stops you from doing customary work.

Not sure if your illness or injury’s covered? Eligible SDI claims for California disability may include:

  • Pregnancy leave
  • Caring for a sick relative who needs hospitalization, hospice care or medical treatment in a residential facility
  • Recovery from elective surgery
  • Any disability your doctor expects to last several weeks or months, but probably not more than one year

After approval, SDI claimants get paid benefits every other week for no more than:

  • 52 weeks if you work for a covered employer
  • 39 weeks if you’re self-employed and purchase your own elective coverage

The state looks at how much you earned at work during the 5-17 months before your disability started. These 12 months make up your “base period,” which the state then divides into four quarters. Then, they use whichever quarter you earned the highest wages to determine your SDI benefit amount. In most cases, SDI payments equal 60%-70% of the wages you earned before your disability stopped you from working.

Unlike SSA-administered federal programs, you can work part-time while receiving the maximum California disability payments you qualify for from SDI.

Bonus Tip: Be sure to file your SDI benefits application in a timely manner! You must apply no later than 49 days after your disability starts to qualify for California disability benefits. If you wait longer than that, you must include a letter explaining why you missed the deadline to file.

How Federal Social Security Disability Insurance (SSDI) Benefits Work

The Social Security Administration (SSA) manages a federal benefits program very similar to California SDI that’s called SSDI. However, SSDI doesn’t cover temporary disabilities lasting less than a year. (The agency makes some exceptions for rare or terminal illnesses covered under the SSA’s Compassionate Allowances initiative.) Below, we’ll answer the most common questions we get about applying for SSDI benefits.

1. Who’s Eligible to Apply for SSDI?

We mentioned some exceptions to California’s SDI program coverage above. In a similar way, everyone who works isn’t automatically covered under the federal SSDI program. Here’s how to tell whether you have SSDI coverage before you apply:

  • Did you work 5 in the last 10 years full-time at a job that withholds FICA taxes from every paycheck? If not, then you cannot qualify for California disability benefit payments under the SSDI program. Some people not eligible for SSDI include service-industry workers (bartenders, waitstaff); union members (teachers, firefighters) and federal or state employees. In addition, if you stopped working more than five years ago, you also won’t qualify for SSDI. That’s because SSDI is a federal disability insurance program. Once you stop paying your premiums for 60 continuous months, your coverage automatically lapses.
  • Does your doctor say your condition will last for at least one year or result in your death? If your condition improves enough for you to start working again in less than 12 months, your claim’s automatically denied.
  • Are you at least 18 years old, but younger than 64? Again, SSDI is a disability insurance program that covers working-age people in the United States. If you’re too young and haven’t earned 40 work credits, you might not qualify. But if you’re already at or past your full retirement age, then you’re no longer eligible for SSDI. Read this to learn why you cannot receive regular Social Security and SSDI at the same time.

If you can answer “yes” to all three questions listed above, then go ahead and apply for SSDI.

2. How Long Does It Usually Take to Get SSDI?

On average, it takes the SSA 3-5 months to review every SSDI claim. That’s why we recommend applying for state California disability first! That way, you have some income while the SSA reviews your SSDI claim. In addition, the SSA enforces a required five-month waiting period before you can get paid any SSDI benefits. Unfortunately, only 1 in 5 first-time SSDI claimants get approved for benefits on their first try. Since just 35% of all SSDI applicants eventually get approved, we strongly recommend getting a lawyer to help you file.

All Social Security lawyers work on contingency. That means they don’t get paid unless your claim’s approved. Nearly 2 in 5 applicants get denied benefits for simple paperwork mistakes. If this happens to you, you’ll likely wait another two years (on average) before getting that first SSDI payment. In January 2019, the SSA added another step just for California disability applicants in Los Angeles. This new step’s called Reconsideration, and it only applies if your claim’s initially denied. Right now, it takes 19-22 months to get your SSDI appeals hearing scheduled in Los Angeles. (In March 2019, the national average wait time for an SSDI appeals hearing was 530 days, according to the SSA.)

How soon can you get your first SSDI payment? No sooner than six months after you apply, period. With a CAL condition that fast-tracks your approval, you’ll get your first payment during the sixth month after applying. Last year, California disability claims for SSDI took 609 days to process, on average. But if you live in Los Angeles, reconsideration adds another 100 days to your average claim processing time. That’s 2.4 years before many approved California disability applicants see their first SSDI payment.

3. How Much Can California Disability Applicants Get Paid In SSDI?

The maximum SSDI payment amount for 2019 is $2,861/month. However, the average monthly SSDI benefit for disabled workers nationwide is $1,234/month. The SSA determines your benefit amount using your highest average wage earnings over a 35-year period. However, the max SSDI benefit amount you receive each month may change in years with a cost-of-living-adjustment (COLA) increase.

4. Are Monthly SSDI Payments Permanent After Claim Approval?

No, SSDI payments aren’t permanent. Once approved, the SSA re-checks your disability status every 3, 5 or 7 years until you reach full retirement age. When you turn 65, 66 or 67 (depending on your birth year), SSDI automatically convert into Social Security retirement payments. The amount you get paid in monthly benefits will not change, and you don’t need to file any forms. Your benefits automatically convert from SSDI to retirement upon reaching your FRA birthday.

Bonus Tip: Make sure to buy copies of your full medical records from your doctor to submit with your SSDI application. You need convincing evidence that proves your condition stops you from working at least one year to qualify for SSDI!

How Federal Supplemental Security Income (SSI) Benefits Work

If you haven’t worked 5 in the last 10 years full-time or are 65 and older, then apply for SSI. SSI is a federal assistance program designed to help the lowest-income Americans financially each month. It has the strictest eligibility requirements of all three programs. Plus, SSI benefits typically offer much less than you’d normally get paid in California disability or SSDI benefits.

1. SSI Medical Eligibility Requirements Are Identical to SSDI

You must be blind or meet the SSA’s definition of “disabled” to meet the medical qualifications for SSI. Both programs offer more permanent California disability benefits to residents with health issues than the state’s SDI program does.

2. You Must Have Very Low Income and Almost No Assets To Qualify for SSI

As an individual SSI applicant, you cannot receive more than $771 each month in passive income to qualify. The SSA defines “passive income” as any money you receive regularly, like earned interest, alimony or child support payments. In addition, you must own less than $2,000 in financial assets to qualify for SSI payments. This includes things jewelry, stocks, bonds and your bank account, 401(k) or IRA balances. However, the SSA won’t count certain items towards that asset limit, including:

  • Your house and the land it sits on, if you own it
  • One primary vehicle your household uses for daily transportation
  • Your wedding ring, furniture, clothing and some durable goods (kitchen items, appliances, bedding, towels, etc.)

Pretty much anything else you can sell for cash is considered an asset that counts toward your SSI max amount. For eligible couples, the max asset limit is $3000 and your active or passive income must fall below $1,157/month.

3. SSI Payments Max Out at $771/Month Per Person, or $1,157/Month Per Couple

Again, this need-based federal aid program helps the poorest Americans who are blind, disabled or over 65 make ends meet. And the SSA will look for anything that may disqualify you from getting SSI benefits. Do you live rent-free with a relative or get free meals at church every Sunday? Those things will count as money towards your SSI income limit.

And if you don’t declare these items in hopes of getting paid more in SSI, watch out. The SSA regularly checks in with SSI recipients every three years to confirm their eligibility status hasn’t changed. If they think you lied about anything, you may receive an SSI overpayment letter in the mail. That means you’ll have to pay back any SSI benefits the SSA says you received in error. In many cases, they’ll garnish your benefits if you can’t pay the whole amount you owe back at once. They can also garnish your IRS refunds for any back SSI payments you owe.

You May Qualify for Legal Assistance

Applying for California disability benefits is often confusing, since you have three different programs to choose from. If you need help, why get an experienced Social Security attorney to help you? You can get confidential answers that apply to your specific California disability questions for free! All California disability lawyers work on contingency, so you’ll pay nothing for claim help now.

Already denied benefits? A California disability lawyer can review your claim and fix any mistakes. Just remember: You won’t pay anything unless a California disability lawyer helps you win benefits. And if you do win, you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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