EDD

What happens to my state disability insurance (SDI) benefits if my baby is overdue? 

Pregnancy is beautiful, pregnant women are goddesses, pregnant bodies are perfect…yada yada yada. It’s all unicorns and rainbows until you get to around 38 weeks and you feel more like this…

Only about 4-5% of babies are born on their actual due date, so the chance of delivering past 40 weeks is totally common and normal. As you begin thinking about when to start your maternity leave – and so much of that is based around the expected due date – let’s discuss what happens to your Pregnancy Disability Leave (PDL) and State Disability Insurance (SDI) in the event your baby decides to take his/her sweet time entering this world.

In case you haven’t read the Maternity Leave 101 post, here’s some background info to get you up to speed.

In California, as long as you work for an employer with over 5 employees you are eligible for Pregnancy Disability Leave, which provides up to* 17.3 weeks (as certified by your doctor) of unpaid job protection for disability due to pregnancy, childbirth and other related conditions. *The actual duration of your PDL is for however long your doctor has certified, but the “standard” duration for a normal, healthy pregnancy and childbirth is 4 weeks before estimated due date and 6 weeks after for a vaginal delivery or 8 weeks for a c-section. Should you have any complications before or after birth, your doctor can certify an extension past this “standard” duration.

While your job is protected (unpaid) under PDL, you may be eligible to receive partial wage replacement through State Disability Insurance (SDI). SDI begins on the first day of your PDL (minus the 7-day unpaid waiting period) and continues through the entire duration you are “disabled” by pregnancy and childbirth. Through SDI, you’ll be paid either 60% or 70% of your normal wages. Read here for the full rundown on how to calculate your SDI benefits.

So, if the “standard” is to start maternity leave at 36 weeks, what happens if you’re late? Don’t you worry – the system’s got you covered! Regardless of how late you are, your pre-birth PDL time will simply be extended until you give birth, and your post-birth recovery time will apply accordingly to how you delivered.

Example: You start your leave at 36 weeks but you don’t give birth until 41 weeks via c-section: Your PDL/SDI will start at 36 weeks (minus the 7-day unpaid waiting period for SDI), you’ll give birth at 41 weeks, and you’ll continue your PDL/SDI until 8 weeks postpartum for your c-section delivery. Screen Shot 2018-03-06 at 3.18.31 PMExample 2: If you’re overdue by 2 weeks (gasp!), same sitch. Your pre-birth PDL/SDI time will simply be extended until week 41, you’ll give birth at 42 weeks, and you’ll continue with PDL/SDI for however long necessary for post-birth recovery (either 6 weeks for vaginal, 8 weeks for c-section, or longer if medically necessary).

Also, on the flip side, if your baby comes early – which is also common – you’ll simply have PDL/SDI (minus the 7-day unpaid waiting period for SDI) up until the day you give birth, and continue with PDL/SDI for however long necessary for post-birth recovery.

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This is why I’m such a major advocate of starting your maternity leave 4 weeks before your estimated due date. It’s a “use it or lose it” scenario, so why not take advantage of every free day before boarding the New Parent Train. Choo Choo!

I should also make super clear that having a late or early baby won’t affect any of your post-birth entitlements. No matter when you actually have the baby, as long as you have available PDL time remaining (i.e. no complications during pregnancy that required you to start PDL way early), you’ll still get the 6 or 8 weeks of PDL/SDI after the baby is born per usual protocol (or more should you need medical extensions). Also, if eligible for CFRA, following PDL you are entitled to an additional 12 weeks of unpaid job protected leave for bonding with baby. During which time, you can receive wage replacement through PFL. For more info on CFRA/PFL, head on over to that Maternity 101 post, or here if you aren’t eligible for CFRA.

IMPORTANT NOTE: Once you give birth, you must report your birth to the EDD (the folks who manage SDI) by submitting the Request for Delivery Information (DE 2513) form typically found in your EDD inbox. That form will give the EDD the heads up on your delivery date and how you delivered, and they will adjust your claim dates accordingly.

Hope that helps any pre-birth anxiety in regards to your maternity leave benefits!

 

Using Sick, Vacation and PTO while receiving SDI and PFL

EDITOR’S NOTE: As of January 1, 2018, SDI and PFL claim benefit amounts have been increased from 55% to either 60% or 70%. The examples provided below still use the outdated 55% SDI/PFL information; however, the information remains consistent. 

It’s no secret that you’re going to try to stretch out every last minute and dollar out of your maternity leave. No shame in that game! One obvious method is to utilize any of your accrued sick, vacation, or PTO time to offset the reduction in pay. There are restrictions and regulations to doing this, so read on for more knowledge.

NOTE: The following applies to usage of sick, vacation and PTO while you are receiving wage replacements from State Disability Insurance (SDI) and Paid Family Leave (PFL). 

Sick Leave

The EDD treats sick leave as wages earned, so you can’t receive SDI or PFL benefits for any time you are receiving sick leave wages that are equivalent to your full salary. 

But wait, there’s a caveat to this! You can coordinate or integrate a portion of sick leave pay to make up the difference between the SDI/PFL benefit amount and your normal full wage. So, by combining 45% of sick leave with the 55% SDI/PFL benefit, you can theoretically get 100% of your normal gross weekly wages for the benefit period, or up until you’ve exhausted your accrued sick time. Here’s an example provided by the EDD:

An employee’s current gross weekly wage is $500. The weekly benefit amount from PFL is $275 [note: 55% of $500]. The $500 minus $275 equals a $225 per week wage loss. Consequently, the employer can integrate/coordinate a maximum amount of $225 per week in gross wages to the employee, resulting in the employee receiving the equivalent of his/her normal weekly gross pay.

Integrating/coordinating your sick leave will not affect your eligibility for SDI or PFL benefits. If you and your employer decide to go this route, your HR rep must notify the EDD that only 45% of wages are being paid, otherwise you may be denied benefits.

Vacation Leave

SDI: Vacation pay is not in conflict with SDI benefits, so your employer can pay you vacation time while receiving SDI benefits at the same time.

PFL without CFRA: If an employer requires that vacation be used during PFL, then vacation pay is in conflict with PFL and will need to be supplemented.

PFL with CFRA: If you are CFRA-eligible, an employer can not require an employee to use sick, vacation, or PTO while receiving PFL (as per CFRA reg 11092 b(3)). As such, vacation is not in conflict with PFL, and you’ll be able to receive both at the same time without it affecting PFL benefits.

Additionally for vacation and PFL, regardless of being CFRA eligible, an employer may require you to use up to 2 weeks of accrued vacation (but not sick) before receiving PFL benefits. This has no affect on your PFL amount once it kicks in.

Paid Time Off

While receiving SDI or PFL, PTO pay is considered the same as sick leave wages, if the payments are made as a replacement for sick leave when you’re out on leave.

This means that if you just accrue PTO, as opposed to sick and vacation time, then the only way to utilize PTO to offset pay reduction is to integrate/coordinate it with your SDI/PFL benefits.

Vacation/PTO/Sick Usage Situations

So, now that we’ve gone over how we can use vacation, sick and PTO time, let’s discuss common usage situations.

Unpaid CFRA time: In most traditional maternity leave scenarios (aka uncomplicated pregnancy with vaginal delivery), you’ll get partial pay for 16 out of the 22 weeks of maternity leave via SDI and PFL benefits (see timeline below). [Check out this post for a thorough overview on maternity leave].

FMLA/CFRA Eligible Maternity Leave

FMLA/CFRA Eligible Maternity Leave

As you can see from the timeline, the last 6 weeks of CFRA are unpaid. So, what to do? According to CFRA laws, you can chose (or an employer may require you) to use any accrued vacation time or PTO time during the unpaid portion of the CFRA leave. You can use sick leave during this time only if the leave is for your own serious health condition or any other reason mutually agreed between you and your employer.

SDI 7-day waiting period: There’s a mandatory 7-day unpaid waiting period that you have to serve before receiving SDI benefits. (Benefits are paid once the waiting period has been completed and all other eligibility criteria are met.) During the non-payable waiting period, you are allowed to utilize any form of wages paid by employer (sick, PTO, vacation, etc) to make up for the loss of wages.

As of January 1, 2018, there is no longer a 7-day waiting period for PFL claims.

How did I navigate the system, you ask?

I was able to coordinate/integrate over 100 hours of accrued PTO (my company only did PTO; no separate vacation or sick time) with 160 hours of company-sponsored leave pay (company perk), giving me full pay for about 14 weeks, 6 weeks partial pay, and 4 weeks unpaid during my 24-week maternity leave. Not too shabby, right?

How did you utilize your sick, vacation and PTO time during your maternity leave? Tell us about it in the comments.

Maternity Leave Tip of the Day: 3

THERE IS NOTHING MORE FRUSTRATING THAN TRYING TO CALL EDD! Yes, ALL CAPS, because I’m shouting as I type this. The wait time to speak to a customer service rep can be ridiculously long. But worse – most often – there are too many people on hold so you get disconnected. WTF! You don’t even get a fighting chance!!! Whyyyyyy?

So, here’s a tip that my girlfriend shared with me. It doesn’t work all the time, but on several occasions I have successfully reached an actual human in my first attempt.

Once your claim has been filed, and you’ve set up your pin number (you can do this even when the office is closed via their automated telephone system – instructions here) – follow these steps:

  1. Call EDD at 1-800-480-3287 (disability) or 1-877-238-4373 (PFL) at exactly 7:58 AM. Seriously, as crazy as it sounds, calling two minutes before the office opens is key!
  2. Immediately press “1” two times (once for English, I forget what the other is)
  3. Immediately enter your Social Security Number
  4. Immediately press “1” (to confirm SS#)
  5. Immediately enter your four digit pin (wait to press the last number until the clock on your phone turns to 8:00)
  6. Immediately press “0”
Hope this helps! If you were successful using this trick, tell us about it in the comments below.

How do you file for maternity leave?

You got pregnant: Check! You understand your maternity leave eligibility and rights: Check! [If not, read this post] You’ve talked to your manager and HR team about when you’ll start your maternity leave: Check!

Now it’s time to actually file your claim…but how?

The fastest and most convenient way to file your State Disability Insurance (SDI) and Paid Family Leave (PFL) is through the EDD web site. It’s fairly easy to navigate, but there are some parts that are kind of confusing. Here’s a step-by-step with images of the important screens, courtesy of the EDD.

Registering for an SDI Online Account

Step 1: First thing you need to do is register for an online account by going to http://www.edd.ca.gov/disability/SDI_Online.htm. You can create your account anytime before you start maternity leave, but you won’t be able to submit your claim just yet. More on that later.

Step 2: Once you get to the SDI Registrations Instructions page, click on “Continue to Claimant Registration” in the middle of the screen.

Step 3: Go through the Security and Terms & Conditions pages.

Step 4: Fill out the Account Verification Information page.Screen Shot 2015-07-07 at 3.24.34 PMStep 5: Create a username and password on the Setup Security Information page. Write down your information and store it in a safe place. If you enter the wrong credentials more than twice, your account gets frozen for about 48 hours! 

Screen Shot 2015-07-07 at 3.25.18 PMStep 6: Complete your Personal Profile Information and hit Submit.Screen Shot 2015-07-07 at 3.27.18 PMStep 7: When your account is successfully created, the Account Setup Confirmation page will appear. Try logging in to your newly created account to make sure it’s working! Screen Shot 2015-07-07 at 3.29.30 PM

Filing a Disability Insurance (DI) Claim

Now that your online account is created, you’ll be able to submit your DI claim so that you can get PAID while out on leave. Hooray!

An important heads up: you won’t be able to submit your DI claim until the day you start your leave. If you try to submit the claim before the actual start date of your leave, the system will give you an error message. So, if you’ve created your online account ahead of time, make sure to set up a calendar reminder to complete the claims bit!

Step 1: Log in to your account. Make sure to type in your username and password correctly. It’s worth noting again, if you make several failed attempts the system will lock you out for an extended period of time (around 48 hours)….and it’s SOOO frustrating. In some instances during the log-in process, you may be asked to respond to one or more of the security questions that you set when you created the account – make a note of those answers for future reference too.

Step 2: Once you’re logged in and at the Home page, select “File a New Claim” from the Main Menu on the left side of the screen.Screen Shot 2015-07-07 at 3.37.52 PMStep 3: In the next page, select “Disability Insurance.”Screen Shot 2015-07-07 at 3.38.27 PMStep 4: Read the Disability Insurance Claim Filing Instructions page, and hit Next.

Step 5: The next screen is the Personal Information Page. Info that you’ve previously entered during the registration process will automatically populate here, but just verify that everything is correct, and hit Next.

Screen Shot 2015-07-07 at 3.42.11 PMStep 6: Complete the Employment Information Page. Couple things to note about this page:

  • “Before your disability began, what was the last date you worked”: This is the last day you were physically in the office.
  • “When did your disability begin”: Typically that’s the next business day following your last day worked. Make sure that this date is consistent with what your physician has submitted and/or any Certification of Healthcare Provider paperwork. 
  • “Date you want your Disability Insurance Claim to begin if different than the date your disability began”: In some instances, it makes financial sense to delay your claim start date since the EDD uses your highest-paid calendar quarter during the 12-month base period to calculate your disability payment amount. Check out this post to find out more on how to optimize your disability start date.

Screen Shot 2015-07-07 at 4.05.49 PMStep 7: Enter your company’s name into the Employer Search field. If a match comes up, hit Select. If your employer is not listed, select “Not Found” and you’ll be able to add them in the next screen.

Step 8: When you get to the Declaration page, select the first check box to authorize an electronic signature. Do the same for the second check box and enter the name of your physician/practitioner in the field. Both boxes must be selected to complete your claim. Now, hit Submit to finalize the process.

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Step 9: The Confirmation page will provide a Form Receipt Number – this is super important. You must give your doctor that Form Receipt Number so they can submit their Physician Certificate for your claim. You can also click on the receipt number to print a PDF of your claim. You’re done with filing your SDI claim!

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The EDD usually takes about 14 days to review and process your claim. Once everything has been approved, you’ll receive a Notice of Computation Letter (mine came in the mail, but I think people have been getting them via email recently) that explains your benefit award for your claim as well as the wages used to calculate the award. If all goes smoothly, you’ll be paid every 2 weeks via the EDD debit card.

Filing a Paid Family Leave Claim

Sometime before the final date of your SDI benefits, you’ll get a notice telling you it’s time to file your Paid Family Leave bonding claim. Note, you won’t be able to submit PFL until you’ve stopped receiving SDI. So, if your SDI ends on July 7, submit PFL on July 8. The process for PFL is pretty much the same as SDI.

Step 1: Log into your SDI Online account. Once you’re on the Home page, click on your “Inbox.”Screen Shot 2015-07-08 at 9.13.58 PM

Step 2: You’ll then be directed to the Message Center, and you should have the “Form DE 2501 FP Claim for Paid Family Leave (New Mother)” link waiting in your inbox.Screen Shot 2015-07-08 at 9.16.01 PM

Step 3: Open that message and click the “Forms Available to Submit” link to begin filing your PFL claim.Screen Shot 2015-07-08 at 9.18.54 PM

Step 4: At the Forms Available to Submit Online page, select “Paid Family Leave Bonding.”Screen Shot 2015-07-08 at 9.19.59 PM

Step 5: Answer yes to both questions on the Prescreening Questions page.Screen Shot 2015-07-07 at 4.56.13 PM

Step 6: More questions….answer the following on the Initial Questions page. As previously mentioned, you won’t be able to submit PFL until you’ve stopped receiving SDI. If you try to submit while you’re still receiving SDI – and answer NO to question 2 – you’ll get an error message saying not to submit PFL form until you have stopped claiming disability benefits. Screen Shot 2015-07-08 at 9.22.27 PM

Step 7: Review the DI Claim Information page. If everything looks good – pay special attention to the Final Date date – hit Next.

Step 8: Complete the “Baby Information,” “Paid Family Leave Claim Information,” and “Employer Information” sections on the next page, and hit Next.Screen Shot 2015-07-08 at 9.24.55 PM

Step 9: At the Declaration page, check the box to authorize your electronic signature. Hit Submit to finalize the process.Screen Shot 2015-07-08 at 9.28.38 PM

Step 10: Read the Confirmation page, and you are donezos with filing your PFL!Screen Shot 2015-07-08 at 9.29.13 PM

The EDD will take about 14 days to review your claim. Similar to SDI, once everything is approved you’ll get your payments via the EDD Debit Card.

And that’s it, folks! Okay, that’s actually a lot of steps, but I just wanted this tutorial to be thorough…

Happy Maternity Leave!