Complete California Disability Benefit Program Guide

Important: We updated this article in August 2023 to make sure all info below is correct. Californians whose health problems force them to stop working may qualify for both state and federal benefit programs. If you’re thinking about filing for California disability benefits, we’ll explain everything you need to qualify for monthly payments.

Tips to Maximize Your California Disability Payments

There are 3 programs you can apply to that pay monthly benefits. That said, it’s impossible to qualify for all three payments at once. Each program has its own unique rules. 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 from different programs.

We recommend most California disability claimants apply for benefits from the following programs, in order:

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 people that cannot get 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 rules say you must have a mental or physical condition that stops you from doing customary work. Not sure if SDI covers your current illness or injury? 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 condition your doctor expects to last several weeks or months, but probably not more than one year

If your claim is successful, SDI pays you 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 bought your own elective coverage

The state looks at how much you earned at work during the 5-17 months before your health problems 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 health stopped you from working. Unlike SSA-administered federal programs, you can work part-time while getting the max 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 within 49 days after your condition starts to qualify for California disability benefits. If you wait longer, you must include a letter that explains why you missed the filing deadline.

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 health issues lasting less than a year. Below, we’ll answer the most common questions we get about filing for SSDI.

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 at a job where you paid Social Security payroll taxes? If not, then you cannot qualify for California disability benefit payments under the SSDI program. Once you stop working for 60 months in a row, your DI policy 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, then you cannot get SSDI.
• Are you at least 18 years old, but younger than 67? Again, SSDI is a disability insurance program that covers American workers. If you’re too young and haven’t earned 40 work credits, then you might not qualify. But if you already get early or regular retirement from Social Security, then you cannot qualify for SSDI. That’s because SSDI changes into Social Security retirement benefits once you turn 67.

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 for California Disability Applicants to Get SSDI?

You cannot get paid any sooner than six months after you apply, in most cases. Two notable exceptions are if you have ALS or are on dialysis for kidney failure.

This is because there’s a required five-month waiting period under federal law.

It also takes the SSA 3-5 months to review every SSDI claim, so you won’t hear back for a while. Applying for state-based California disability first could provide some income during your SSDI claim review. Unfortunately, only 1 in 5 people who apply for SSDI get benefits on their first try. Since just 35% of all SSDI applicants eventually get benefits, we suggest getting a lawyer to help you file.

In 2022, California disability claims for SSDI took 597 days to process, on average. But if you live in Los Angeles and have to appeal your first claim’s denial, you’ll wait 2 years for a court date. California disability applicants who win benefits on appeal won’t see their first SSDI payment for almost 3 years.

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

The maximum SSDI payment amount for 2023 is $3,627 every month. However, the average monthly SSDI benefit for disabled workers nationwide is $1,483.

The SSA calculates your SSDI amount using your highest average wages earned over a 35-year period. However, your pay amount may go up in years with a cost-of-living-adjustment (COLA) increase.

4. Are Monthly SSDI Payments Permanent?

No, SSDI payments aren’t for life. Once approved, the SSA re-checks your disability status every 3, 5 or 7 years until you turn 67. After that birthday, SSDI automatically converts into regular Social Security. The amount you get paid will not change, and you don’t need to file any forms. Your benefits automatically convert from SSDI to retirement one month after your 67th birthday.

Bonus Tip: Make sure to buy copies of your complete medical records from your doctor to file with your SSDI application. You need solid proof your health 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 or are 65 and older, then apply for SSI. SSI is a federal assistance program that helps people with very little income make ends meet. It has the most strict rules of all three programs. Plus, SSI benefits usually pay 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 pass the medical exam for SSI. Both SSDI and SSI pay California disability benefits for much longer than the state’s SDI program does.

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

Your household income must fall below $1,470 each month in order to qualify for SSI. This includes both work wages and passive income. SSA defines “passive income” as any money you receive regularly, like earned interest, alimony, or child support. In addition, you must own less than $2,000 in assets to qualify for SSI payments. This includes things like jewelry, stocks, bonds and your bank account, 401(k) or IRA balances. However, the SSA won’t count certain items towards that limit, including:

• Your house and the land it sits on, if you own it
• One primary vehicle used for daily travel needs
• Your wedding ring, furniture, clothing, 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 limit. For eligible couples, the max asset limit is $3,000 and your active or passive income must fall below $1,470 per month.

Important: Don’t lie about your finances when you apply for SSI. If you do, you might 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 back at once. They can also garnish your IRS refunds for overpayments.

3. Monthly SSI Payments Max Out at $914 Per Person, or $1,371 Per Couple

It’s not a lot of money, but everything helps when you can’t work. One thing to keep in mind is that these payments can go up when there’s a COLA increase that year.

Get Free Expert California Disability Claim Help

Confused or worried about whether you’ll qualify for these payments? You can always talk to an experienced Social Security attorney for free on the phone. Having a California disability lawyer file your paperwork makes you almost 3x more likely to get benefits. These attorneys always work on contingency, so you’ll pay nothing for help now. And if you’re successful, then you only owe one small fee after your claim’s approved.

Want to talk to a nearby expert about your claim? Click the button below to start your free online benefits quiz and see if you may qualify:

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