Personal Injury Disability Legal Information
California State Disability Insurance (SDI) is a partial wage-replacement insurance plan for California workers. The SDI program is State-mandated, and funded through employee payroll deductions. SDI provides affordable, short term benefits to eligible workers who suffer a loss of wages when they are unable to work due to a non related work injury illness or injury, or a medically disabling condition from pregnancy or childbirth.
The majority of California employees, approximately 12 million workers, are covered by the SDI program. Some employees are exempt from SDI; for example, railroad employees, some employees of nonprofit agencies, employees who claim religious exemptions, and most government employees.
Benefits of California SDI Coverage
- SDI coverage "travels" with the worker. Coverage is not dependent on staying with a specific employer.
- SDI coverage is mandatory for most California workers.
- SDI is non-exclusionary. An eligible worker's coverage cannot be canceled or denied because of health risk factors, pre-existing medical conditions, or hazardous employment.
- SDI may pay up to 52 weeks of benefits with a waiting period of only seven days.
- Payroll deductions for all covered workers are based on the same low contribution rate.
One quarter of workers will experience a disability before reaching retirement age, disrupting their ability to work and provide for their families. For those who suffer from injury or illness and cannot work, disability insurance can provide an important source of income. There are strict legal requirements governing all aspects of disability insurance, from filing claims and challenging a denial to qualifying for benefits. Dealing with disability insurance can be challenging, given the technical legal and medical issues involved, the requirements of insurance policies, and the possibility of being denied coverage. Fortunately, Findlaw's disability section has information and resources to help answer your disability questions.« Show Less
In this section, you'll find resources to help you deal with issues related to disability insurance. You can learn about the difference between long- and short-term disability insurance, private insurance and Social Security disability benefits, different definitions of disability, how to apply for benefits and file a strong claim, and what to do if your disability claim is denied.
Qualifying for Disability
The definition of disability varies, depending on your insurance policy. Many private disability insurance policies, the kind you buy for yourself or get through work, will provide benefits if injury or illness prevents you from meeting the duties of your current job. Others, like Social Security disability insurance, use stricter definitions of disability. These will only provide benefits if you can no longer do any job at all. Some policies require you to be unable to work for several months before receiving benefits, but other policies, like short-term disability insurance, only provide benefits for a limited time. Understanding your plan's definition of disability can be key to qualifying for disability benefits.
Applying for Benefits
Filing a claim for disability can be a complex task. If your disability insurance is provided by an employer, federal regulations establish strict requirements for processing and responding to your claims. Your insurance provider is required to inform you of your plans requirements, including any time limits and deadlines for filing and any conditions that can be excluded from disability coverage. If you are applying for Social Security disability insurance, you'll need to provide detailed information regarding your disability. Learning about the process beforehand can help you prepare and avoid potential issues that could harm your claim.
Many people successfully get disability benefits on their own, without a lawyer's help. The initial application usually doesn't need a professional, unless the applicant is unable to manage the task alone. Once your case has been denied, though, a lawyer is extremely helpful in getting an award through the appeals process.
Experienced Attorneys Understand the Medical Evidence Needed to Win
The single most important factor to winning a claim is having the right medical evidence. Applicants frequently don’t know exactly what to give the Social Security Administration (SSA) and may end up submitting too much irrelevant information and too little of what matters.
Represented applicants are more likely to win because, in part, disability attorneys know how to develop the evidence needed for an approval for that client's particular medical conditions. When a disability attorney gets a case, he or she reviews the applicant's file carefully to determine whether any additional tests or medical records are necessary. The attorney will then work with the applicant to get the necessary records and submit them on time to the SSA. The attorney will also make sure that irrelevant information is not submitted, which is important if the claim goes to the hearing level, because administrative law judges (ALJs) often become aggravated if they have to sift through pages of irrelevant records.
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