< Back to California Disability

Connor O'Neill

ACL tear - file EDD SDI claim now or wait for surgeon appointment? How does backdating work?

I tore my ACL during a pickup basketball game on January 2nd and I'm completely unable to do my job as a warehouse supervisor (lots of walking/standing). My primary doctor confirmed the tear with an MRI and gave me a note to stay off work for now, but I've been referred to an orthopedic surgeon who I won't see until February 1st. I'm confused about how to handle my SDI claim: 1. Should I file now using my primary doctor's info even though surgery and real recovery timeline is unknown? 2. If I wait until after meeting with the surgeon (3+ weeks away), can my claim be backdated to when I actually stopped working? 3. Do I lose benefits if I don't file immediately? 4. Has anyone dealt with SDI claims for ACL surgery specifically? How long did they approve? This is my first time dealing with disability and I'm getting confusing advice from coworkers. One says file now, another says wait for the surgeon who'll be managing my actual recovery. Help!

LunarEclipse

•

File your claim NOW! Don't wait for the surgeon appointment. Your disability begins the day you stopped working due to your injury, regardless of when surgery happens. Your primary doctor can certify your initial claim. The surgeon can provide updated medical certifications later that extend your claim period after surgery. You can backdate a claim, but only up to 49 days, and you lose benefits for days beyond that window. So if you wait too long, you're literally leaving money on the table. I tore my ACL in 2023 and the process works like this: 1. File claim with initial doctor's certification 2. Get approved for initial recovery period 3. Surgeon later submits updated medical certification for post-surgery recovery 4. Your claim gets extended based on surgical recovery timeline

0 coins

Thank you for the clear explanation! I didn't realize there was a 49-day limit on backdating. I'll file tomorrow using my primary doctor's certification. Do you remember how many weeks EDD approved for your ACL recovery? I'm trying to budget for this time off.

0 coins

Yara Khalil

•

my friend waited 2 get his SDI claim going after acl surgery nd it was a NIGHTMARE!!! file now w/ your regular doc then just update later... surgeon will probly give u 3-6 months off work depends how physical ur job is. warehouse work means longer recovery fs

0 coins

Keisha Brown

•

As someone who works in healthcare admin, I completely agree with filing your claim immediately. Here's why: - Your disability period officially starts the first day you were unable to work (in your case, January 3rd it sounds like) - Your primary care physician's certification is completely valid for starting the claim - The EDD form (DE 2501) has a section for "estimated return to work date" - your doctor can put a date that gets you through to when you'll see the surgeon - Once you meet with the surgeon and have surgery scheduled, your surgeon will submit a new certification with updated recovery timeline - This creates a seamless extension of your claim without interruption in benefits I've seen patients lose weeks of benefits because they waited for specialist appointments before filing. Don't make that mistake!

0 coins

this is 100% right! i made the mistake of waiting and lost almost 2 weeks of benefits because i thought i needed to see the specialist first! BIG MISTAKE

0 coins

Amina Toure

•

When I tore my ACL in 2024, EDD approved me for 8 weeks initially, then after surgery they extended it to 5 months total based on my surgeon's certification. But I think every claim is different depending on your job requirements and recovery progress. BTW - I tried calling EDD about extending my claim after surgery and spent HOURS on hold. Eventually I found Claimyr (claimyr.com) which got me connected to an EDD rep in under 25 minutes. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd It saved me so much frustration when I needed to make sure my extension was processed correctly. Might be worth checking out if you run into phone issues with EDD.

0 coins

Oliver Weber

•

Is claimyr legit? i've been trying to call EDD for 3 days straight about my claim and it's driving me NUTS.

0 coins

Amina Toure

•

Yes, totally legit. I was skeptical too, but after trying to get through to EDD for a week, I was desperate. They basically handle the waiting/calling for you and then connect you once they get through to an actual person. Saved me hours of listening to hold music and getting hung up on.

0 coins

FireflyDreams

•

DONT LISTEN TO ANYONE SAYING WAIT!!!! The system is DESIGNED to make you lose money!!!! I waited after my back injury because the first doctor said "wait until you see the specialist" and I LOST 3 WEEKS OF PAYMENTS I could never get back!!!! File NOW and here's the important part - on your DE 2501 form, make sure your doctor fills out the "date you became unable to work" with the ACTUAL FIRST DAY you missed work, not today's date!!!! This is how they try to screw you!!!!!

0 coins

Oh wow, thanks for the tip about making sure the date is entered correctly. I stopped working on January 3rd (day after injury) so I'll make sure that's what gets put on the form.

0 coins

i tore my acl skiing last year and my surgeon gave me 4 months off for my construction job. but my buddy who works a desk job only got 6 weeks after the same surgery. depends on ur job i think

0 coins

Thanks everyone for the helpful advice! I went ahead and filed my claim yesterday with my primary doctor's certification. She estimated 8 weeks for the initial certification but said we'll update it after surgery. I didn't realize how important filing quickly was - that 49-day backdate limit really could have cost me if I'd waited until after surgery and recovery. One more question - does anyone know how closely EDD reviews the paperwork? I'm nervous because my doctor wrote that I was injured on January 2nd but I worked half a day that day before going to urgent care. My first full day missed was January 3rd.

0 coins

Keisha Brown

•

That's not an issue at all. The "date of injury" and your "first day of disability" can be different dates. What matters for payment is the first full day you couldn't work due to your medical condition (January 3rd in your case). Just make sure your doctor indicated January 3rd as the first day of disability on the form, not the injury date. Also remember you don't get paid for the first 7 days of disability - that's the mandatory waiting period for SDI benefits.

0 coins

I had a completely diffrent experience with my shoulder surgery last year. My regular doctor wouldn't sign the SDI forms at all and said only the surgeon could do it. Maybe different doctors have different policies? Anyone else run into that problem?

0 coins

LunarEclipse

•

Yes, this does happen sometimes. Technically any licensed physician can certify your disability, but some primary care doctors prefer not to certify for conditions that are being treated by specialists. If your primary doctor refuses, you can: 1. Ask them to at least certify for the period until your specialist appointment 2. See if they'll speak to the specialist's office to coordinate care 3. Request an earlier appointment with the specialist specifically for SDI certification 4. In some cases, the urgent care doctor who initially treated you can certify But the OP is fortunate their primary doctor was willing to complete the initial certification.

0 coins

Amina Toure

•

Just to add one more important thing - make sure you certify properly every two weeks once your claim is active! The EDD won't automatically send your payments if you don't complete the bi-weekly certification. I missed one certification period and my payments got delayed by almost 3 weeks while they sorted it out.

0 coins

Thanks for the reminder! Is the certification done through the SDI Online portal? And is it something my doctor needs to do every two weeks, or just me?

0 coins

Amina Toure

•

Just you! You'll log into SDI Online and there will be a button to complete your certification when it's time. They'll ask if you worked during the period, if you received other income, etc. Super simple but easy to forget when you're dealing with recovery. I set calendar reminders so I wouldn't miss them.

0 coins

StarStrider

•

Just wanted to share my recent experience since it might help! I filed an SDI claim for a knee injury in December and was really glad I didn't wait. My primary doctor was able to certify me for 6 weeks initially, which got my benefits started right away. When I eventually had surgery, my orthopedic surgeon just submitted an updated certification that extended my claim seamlessly. One tip that really helped me - when you meet with your surgeon on February 1st, bring a copy of your current SDI claim number and ask them specifically about timeline for return to work for your type of job. Warehouse work is definitely going to require longer recovery than a desk job. My surgeon was really helpful in being realistic about the timeline once she understood what my daily work tasks involved. Also, don't stress too much about the paperwork details. EDD processed my claim pretty smoothly as long as all the required sections were filled out. The key thing is just getting it filed ASAP like everyone else said. Good luck with your recovery!

0 coins

California Disability AI

Expert Assistant
Secure

Powered by Claimyr AI

T
I
+
20,087 users helped today