State Disability Insurance for Pregnancy Leave

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  • Need help navigating EDD's denial of my maternity leave

    – Oct 25, 2022
    (8 replies)

    Hello - I am self-employed, about to have a baby and have been denied CA state disability even though I think I qualify. I am currently appealing the decision but I'm struggling with the lack of transparency and guidance from EDD. Does anyone have a resource for helping navigate the appeals process or someone with a thorough understanding of CA disability and paid family leave policies to see what my options are at this point?

    Oct 25, 2022

    EDD is a mess since the pandemic. Please call your state senator or legislator to help you. I am lawyer. We have no more access to the system than you do. Your elected representative has an aide with an EDD hotline

    Hi there — 

    I was l having trouble as well and it turns out I filled out my paperwork wrong. Each state congressional member actually has an EDD liaison assigned to their office. If you call your congressional member they can help you. It may work to try this first before a lawyer. I did this for myself and they fixed my application in less than a week and also helped for my PFL. You can use this to determine who to contact: https://findyourrep.legislature.ca.gov 

    To qualify for disability and paid family leave if you're self-employed, you have to pay into Disability Insurance Elective Coverage (DIEC). You must have been paying into DIEC for at least six months before you can apply for disability or PFL, and you have to stay in the program for two full years or they will ask you to repay any benefits. So first--confirm that you enrolled in DIEC before last May. The EDD website tracks contributions, or you can gather any payment receipts you have. Disability and PFL payments are also based on your earning during your "base period," so earnings during those quarters will determine your benefits. (These are the earnings you report to the state each quarter.) For a claim starting this month, they'll be looking at your earnings from July 1, 2021, through June 30, 2022.

    I don't think you need a lawyer at this stage--go through the appeals process first if you're sure you're enrolled in DIEC and have made the necessary payments. Collect the receipts for your DIEC payments and for your quarterly taxes--if you file online, they should have this all in their system, but if you file paper-based returns there may be a lag in processing them. Hopefully once they have everything documented clearly, they'll reverse the appeal. Good luck!

    You might consider contacting your State Assembly person. A different context, but I was having an issue with getting EDD to process a PFL claim and after contacting my Assembly Member, Mia Bonta, had it processed in just a few days. It's clear from the process I worked through w her office that they are set up to deal w a lot of constituent issues with EDD

    I recently went through the process for disability & paid family leave and I'm self employed. Feel free to message me. Basically, you have to have paid into voluntary disability insurance prior to taking leave or have W-2 income from which state disability is paid out. I had a client pay me last year on a W-2 and those earnings qualified me for disability. 

    I don't think Akiko is a lawyer, but she does run https://www.maternityleave411.com/ and was an INVALUABLE resource for me as I tried to figure out what leave my partner and I were entitled to, and how to apply, and how to talk to my employers... it was literally the best prenatal money I spent, and I felt it was quite inexpensive for the value I got.

    She reviewed all our employee handbooks and union documents to see how those benefits fit with the state programs, and she created a leave schedule we brought to our employers based on our goals (do you want to take all the leave you can, or just the paid leave, etc. -- you tell her what you want). She also provided step by step instructions for how to apply for the different types of leave on the EDD website and how to answer the Qs so as not to get my claim flagged. So, she is quite the expert in CA parental leave and I would strongly suggest reaching out!

    Having just come off my PDL & PFL, I can testify that the EDD is an absolute chaotic mess even under "normal" circumstances. I 100% agree with the folks who say to contact your state rep. It might sound random, but I basically got a case worker who helped move my claim through. The EDD will not answer your calls. Your state rep will respond to your email within 48 hours. Good luck!

    I think contacting your state rep is a great idea. Another thing I would try is calling Legal Aid at Work's Work and Family hotline: https://legalaidatwork.org/our-programs/work-and-family-program/ 

    EDD is so frustrating. I'm an attorney but not in this area of law and I had a lot of issues getting the correct payment amount. Good luck!

  • Maternity Leave Options & Benefits for Self-Employed Mom?*

    – Sep 9, 2020
    (2 replies)

    I am looking for updated information. All the posts I have found are really old.

    Sep 9, 2020

    If you're self-employed, you are hopefully paying into the CA Voluntary Plan Disability Insurance Program through the EDD, which covers disability and paid family leave for those who are self-employed. Benefits are based on your highest paid quarter in the past year. If you haven't opted into this program yet and are newly self-employed, you may still be able to begin paying in now and a quarter of your wages under your former employer can also be counted. If you have been self-employed for over a year but haven't paid into the program, you unfortunately don't have a lot of options, although it's still worth opting in now if you will be working for at least another few months, because you can use the paid family leave any time in the baby's first year. (Disability coverage is only for 6-8 weeks after your child's birth.) The EDD website has instructions on how to set up your account and on how to begin paying in if you aren't already doing so. Congratulations!

    I agree with what the previous poster said, and would add two things. #1) You have to start paying into the program two quarters (they measure everything in quarters starting Jan, April, July, Oct) before you use the benefits. So if you sign up and start paying right when you know you're pregnant, you should be able to get in two quarters before you have a baby and need to take the benefits. And #2) They require you to pay in for two whole years. So if you just start paying in right when you find out you're pregnant, you have to keep paying for a year a half after you're done collecting benefits. I did the math and it was worth it for me, but it's a pretty important part to know. Also my payments changed over the course of the two years because they constantly adjust it based on your income. Also, I did make the program work for me and I'm glad I did it, but they have the worst website I've ever encountered, anywhere. Good luck!

Archived Q&A and Reviews

Can I get disability if I don't plan to return to work?

April 2002

I have a more specific question that isn't answered on the State's website about maternity leave. I know that California offers up to 4 weeks pre-delivery and 6 weeks post-delivery of partially paid disability/maternity leave for working eligible mothers-to-be. My question is: Do you have to return to your job after the 6 weeks in order to qualify? Or, can you be paid up to 6 weeks, and not return to work? In other words, if I tell my employer ahead of time that I do NOT intend to return, can I still qualify for the money? If not, I suppose the unethical way to qualify would be to take leave under the pretense of returning after 6 or 12 weeks, but not really return... I'm avoiding questions about my future with my employer until I know more about this California maternity leave law. I do not plan to return to work after delivery, but I would love to get a bit of money that I've ''earned'' from deductions from my paychecks all these years! By the way, I'm not referring to FMLA rules, but the specific State law that offers paid disability leave for maternity. Thanks for any information you can provide! mom-to-be

The forms that you'll get from Disability with every check ask you if you're well enough to work and if you've gone back to work, yet. The state is mainly interested in whether you're still disabled. I think you'll find that the fact that you're not intending to return to work is not an issue. Gwynne
YES! You can collect disability! I had no intention of going back to work and my employer knew that. You are still entitled to received the disability payments for the full 6 weeks after birth! Don't feel guilty - you earned it. Jaime
I don't know the answer to your question, but I would recommend calling 1-800-480-3287. I called this number and asked a million complicated questions about California maternity disability coverage, and the woman answered them all pretty easily. It made me wish I hadn't spent so much time wandering aimlessly around the web site. sonya
It's my understanding the you have to be _disabled_ as a result of your preganancy in order to collect this payment - i.e., baby-bonding time does not count as disabled time. Only if you are ordered bed rest or have complications would you be able to collect anywhere close to the full time period. Your employer may sponsor an additional SDI (short term disability) privately that is more flexible than the state. good luck. Cynthia
I remember doing this research and asking the same questions, I also remember getting a different answer from every person I talked to when I called the Disability Department. I was told that yes, you must plan to return to work after your disability ends, and if you were to give notice now you wouldn't qualify. Jill
I received state disability payments until 6 wks postpartum without returning to work. All the paperwork was between me and the state; my employer was not involved at all. When I filled out the initial paperwork, my care provider indicated that I should receive payments until 6 wks after my due date because I told her that I would be out of work at least that long. Also, FYI, during my pre-delivery leave, in which I also received disability payments, I worked some scant part time hrs, and reported those to the state, but it didn't affect my disability check amounts. Also FYI, our accountant just told us that it wasn't necessary to report this as additional income on our income taxes. Halle
I took pregnancy disability and did not return to work for an additional 4 months afterwards. If you have paid into SDI, and you are medically qualified for it, you should get your post birth six weeks disability money regardless of how long you stay off work. It is between you and the state, not you and your employer. I completed the application myself, had my doctor approve it, and sent it directly to the state. My only advice is to make sure you send back the ''you are still disabled'' part of your disability paystubs, or else the next check won't come. Sherri

Maternity disability for self-employed mom?

 March 2002

My first baby is due in one month. I have heard that it is possible to claim diability insurance from the State of California during this time. Yet, I do own my own business and am not sure quite how to claim it. Does anyone have experience with this? Thank you. Shira

As a self-employed individual, you are eligible for State Disability Insurance (SDI) if you've elected to pay for the coverage and have done so for some period of time (I forget how long you would have needed to pay in before you can collect). You can address questions as to whether you are covered to EDD (the State Employment Development Department which administers SDI).
Yes, you can file for disability. You should check with your doctor; very often the doctor's office will have the appropriate forms. If not, try the Web. The page for disability insurance is here:

http://www.edd.ca.gov/diind.htm

(My employer was so new, they didn't have any forms, and I had to go through the state to get all my forms.)

The state pays only for the time you are disabled, that is, unable to work. In my case, I sent away to the state for the form. I filled out most of it and left the form with my doctor's office. The day my baby was born, the doctor's office filled in the begin date on the form and filed the claim for me. Gwynne

I just looked into this. I own my own business, as well. From what I understand (and I don't understand it all that well), you need to pay the state for a certain period before you are eligible to receive the benefits. It seems that self-employed people can start paying into the program a few months before delivery (I'm not sure how long). I, however, was employed full-time last year, which means I am still eligible for the benefits I paid for through my old job. Basically, you should call Dave Shellhouse, in charge of elective coverage, at 916-464-2500. There is also some basic information on the State of California web site. Good luck! sonya
Response to question re disability insurance: As a self-employed individual, you are eligible for State Disability Insurance (SDI) if you've elected to pay for the insurance and have done so for some period of time (I forget how long you would have needed to pay in before you can collect). You can address questions as to whether you are covered to EDD (the State Employment Development Department which administers SDI). Amy