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 state disability insurance (SDI) in the event your baby decides to take his/her sweet time entering this world.

In California, you are eligible for state disability insurance (SDI) for 4 weeks before your due date, and then 6 to 8 weeks after the actual birth of your baby (6 weeks for vaginal birth and 8 weeks for cesarian birth). Through SDI, you’ll be paid around 55% of your wages. Read here for the full rundown on maternity leave, job protection, and pay while on leave.

If you decide to start your leave at 36 weeks and your baby is born a week late at 41 weeks, your SDI situation won’t be affected one bit since there’s a mandatory 7-day unpaid “waiting period” before SDI kicks in. You’ll basically be on leave for 5 weeks before the baby actually arrives, but since that first week is unpaid, you’ll still get SDI for the full 4 weeks.

Now, what about if you are overdue by 2 weeks? Gasp! Will you still receive SDI benefits up until your baby is born even if it goes beyond 4 weeks? You betcha! As long as you are still certified as “disabled” by your doctor (SDI considers pregnancy a condition that can prevent you from working) you will still receive benefits. If you don’t hear from the EDD (the folks who manage SDI) regarding the status of your baby’s birth, it might be a good idea to give them a call to provide an update.

I should also note that having a past-due baby won’t affect any of your benefits post delivery. No matter when you actually have the baby, you’ll still get the 6-8 weeks of SDI benefits after the baby is born per usual protocol, plus any bonding leave and pay.

By the way, if your baby comes early – which is also is common – you’ll simply get SDI benefits (minus the 7-day “waiting period”) up until the day you give birth. 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!

What happens if I don’t go back to work after maternity leave? Are there penalties?

The question of going back to work after maternity leave isn’t always an easy one, especially if you’re on the fence. Whether it’s a last minute gut decision or something you’ve always planned for, working moms often ask if there are potential ramifications or penalties of not going back to work after leave.

Unless there was a contractual obligation – like a signed agreement – for you to return to work after maternity leave, an employer usually wouldn’t have legal recourse. But, in some instances, an employer can require you to pay back the health benefit premium if you don’t go back. Bahhh, what!? So, before you send in your resignation letter, let’s talk more about the laws allowing employers to recover premiums and what some of the loop holes are.

The following applies to California moms who will take FMLA leave followed by CFRA leave. 

According to CFRA laws, “an employer may recover the premium that the employer paid for maintaining group health care coverage during any unpaid part of the CFRA leave.” (Emphasis is my own). Note the emphasis on UNPAID. If you are eligible to take 6 weeks of paid PFL during CFRA, you’re technically only on the hook to pay back premiums during the last 6 weeks of UNPAID CFRA. Also as a reminder, per FMLA and CFRA laws an employer must maintain your health care benefits while on leave – read more common questions here.

While making the life decision to be the full-time caretaker of your child is an exceptional and valid one, there may be other circumstances that require you not to return back to work. Your employer cannot require you pay back your portion of the premium if your failure to return was caused by the continuation, recurrence or onset of a serious health condition that would entitle you to family or medical leave, or by other circumstances beyond your control. The term “circumstances beyond the employee’s control” is quite nebulous. The CFRA laws don’t specifically define it, but the FMLA does:

“Other circumstances beyond the employee’s control. Examples of other circumstances beyond the employee’s control are necessarily broad. They include such situations as where a parent chooses to stay home with a newborn child who has a serious health condition; an employee’s spouse is unexpectedly transferred to a job location more than 75 miles from the employee’s worksite; a relative or individual other than a covered family member has a serious health condition and the employee is needed to provide care; the employee is laid off while on leave; or, the employee is a key employee who decides not to return to work upon being notified of the employer’s intention to deny restoration because of substantial and grievous economic injury to the employer’s operations and is not reinstated by the employer. Other circumstances beyond the employee’s control would not include a situation where an employee desires to remain with a parent in a distant city even though the parent no longer requires the employee’s care, or a parent chooses not to return to work to stay home with a well, newborn child.” (825.213 (2))

Okay, so now that we know your employer can make you pay back your premium if you don’t go back to work, let’s discuss an interesting loop hole. The CFRA law states that “an employee is deemed to have failed to return from leave if he/she works less than 30 days after returning from CFRA leave.” It goes further on to say that “an employee who retires during CFRA leave or during the first 30 days after returning is deemed to have returned from leave.” What does this mean? According to the laws, as long as you go back to work for at least 30 days there is no risk of you having to pay back your premium.

But here’s the thing…I’m not saying you should just go back to work for 30 days and quit. I’m just simply translating the law. If you absolutely know you aren’t going back to work, or even have doubts, talk to your manager or a trusted HR rep about your situation to confirm these details.

For non-California moms or folks who didn’t take CFRA leave, FMLA laws around this is similar. Read the full text of FMLA laws under the “Employer Recovery of Benefits Costs” section here

 

Using Sick, Vacation and PTO during maternity leave

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

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.

Vacation pay is also not in conflict with PFL benefits, but the rules are a bit fuzzier here as regulations have recently changed. The law used to give an employer the option to require you to take up to two weeks of earned but unused vacation leave before receiving PFL benefits.

However, an update to the CFRA law (as of July 1, 2015) states that, “an employee receiving Paid Family Leave to care for the serious health condition of a family member or to bond with a new child is not on “unpaid leave,” and, therefore, an employer may not require the employee to use paid time off, sick leave, or accrued vacation.” Since there is no 7-day waiting period for new mothers transitioning from SDI benefits to PFL, that means you are immediately starting paid CFRA leave, and therefore, according to the updated law you should not be required to use vacation, sick or PTO time before starting PFL.

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.

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 mentioned above, there is no additional seven-day waiting period for a PFL claim to bond with a newborn when the PFL claim follows the DI pregnancy-related claim.

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.

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.

Screen Shot 2015-07-07 at 4.23.59 PM

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!

Screen Shot 2015-07-07 at 4.29.41 PM

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!

 

 

Maternity Leave Tip of the Day: 2

Not many people will admit this, but being out on maternity leave can get pretty lonely sometimes. You’re so used to being in the office, surrounded by people and all of a sudden you’re alone. Sure, you’re with a baby, but let’s face it – not much two-way conversation can be had there. So, here’s a tip – GET DRESSED in actual “you can be seen outside with that on” clothes. And no, yoga pants don’t count!

On the days that I put on regular clothes, I felt better. I strangely felt less isolated because I felt like I had a connection to the “outside world” and it helped me actually get out the door!

Regular clothes and eating lunch out like a normal person!

Regular clothes and eating lunch out like a normal person!

Which family members do FMLA and CFRA cover?

Super basic question, but I’ve yet to find a simple, easy-to-read answer on the World Wide Web. So, here ya’ go!

FMLA and CFRA both cover the following:

  • Spouses:
    • Husbands and wives
    • Legal, same-sex married couples. As of March 27, 2015, those in legal, same-sex marriages – regardless of where they live – have the same rights as those in opposite-sex marriages to federal job-protected leave under FMLA and CFRA.
  • Sons or daughters:
    • Biological child
    • Adopted child
    • Foster child
    • Stepchild
    • Legal ward
    • Child of a person standing in loco parentis, who is either under age 18, or age 18 or older and “incapable of self-care because of a mental or physical disability.” Loco parentis is defined as someone with the day-to-day responsibilities to care for and financially support a child, or, in the case of an employee, who had such responsibility for the employee when the employee was a child. A biological or legal relationship is not necessary.
  • Parents:
    • Biological
    • Adoptive
    • Step
    • Foster father or mother
    • Any other individual who stood in loco parentis to the employee when he/she was a child. This does not include in-laws.

Additional coverage under CFRA is registered domestic partnerships. Effective July 1, 2015, CFRA leave may be taken to care for the serious health condition of a registered domestic partner, as defined by Family Code sections 297 through 297.5. If you live in California, where the FMLA law and the CFRA law differ, the most generous/less restrictive leave provisions must be applied. 

Additionally, there are couple other bonus coverage areas under California’s Paid Family Leave (PFL) that are worth noting. In July 2014, PFL was expanded to also cover siblings, grandparents, grandchildren and parent in-laws. Under the law, the term “sibling” is defined as “a person related to another person by blood, adoption, or affinity through a common legal or biological parent,” and “parent-in-law” is defined to include the parent of a spouse or domestic partner. Do remember though that PFL only provides partial wage replacement – and does NOT provide job security. So, if you’re thinking of taking leave to care for a sibling, grandparent, grandchild or an in-law, be sure to talk to your employer about job security.

You never know what kind of curve balls life will throw at you. I do feel some relief that federal and state leave benefits extend out to family – blood and non-blood – members. [Cue music!…]

Have you taken leave for an extended family member? Tell us about it in the comments below.

 

Common Maternity Leave Questions

Oh, maternity leave: the never ending abyss of questions and uncertainty. If you’re just starting to navigate the maternity leave waters check out my previous post on how to Milk Your Benefits. After reading about California maternity leave and you’ve found yourself like this, you’re not alone….

confused-britney

To help ease the process a bit, I’ve listed some of the most common questions I’ve been seeing in various “mommy” forums.

1) Can you accrue vacation days while on maternity leave? Typically, no – vacation and sick accrual usually stops when you start your leave. A company may chose to continue sick/vacation/PTO accrual as a benefit, but that is up to the company. Definitely something to confirm when you first talk to HR about your maternity leave benefits.

2) Will I still get health insurance through my company while I’m leave? Yes, you are entitled to the continuation of health benefits through your employer for the entire duration of your leave, up to four months. However, depending on your employer’s policy, you may be responsible to pay the monthly premium. This amount is usually the amount you are paying each paycheck, but get that confirmed with HR too as they may cover some or all of the premium.

3) What’s the best way to fill out the EDD forms? In California, you can file claims for both SDI and Paid Family leave via the SDI Online system.

4) How does my doctor submit the medical portion of the SDI claim? If you submit the SDI claim online, you will be given a Form Receipt Number (FRN) which you have to provide to your doctor. They will then use your FRN to file the physician certificate online (or by mail). IMPORTANT NOTE: Filing online does NOT automatically kick things over to your doctor, you must notify your doc of your Form Receipt Number. Also, your SDI claim is not complete until the EDD gets the certification from your doctor.

5) If I work up until my baby is born will I get more time with my baby? No. Under the Pregnancy Disability state law, most doctors will certify a pregnancy disability leave of 10-12 weeks for a normal pregnancy — 4 weeks before childbirth and 6 weeks after a vaginal delivery (or 8 weeks after delivery by cesarean section). This means that regardless of when you give birth you are either allotted 6 or 8 weeks after birth (then you can 12 weeks of CFRA if you wish. More info on that here). So, my tip: If you can afford it (you will be paid 55% of your weekly wages under State Disability Insurance), definitely take some time before the baby is born to relax and get things organized since it is a “if you don’t use it; you lose it” situation.

I’ll continue to post common questions as I see them. In the meantime, if you have any questions send them my way by commenting below.

Happy Maternity Leave!