Can I get EDD SDI benefits for elective surgery performed outside the US?

i had a friend who got denied for dental work in mexico last year, edd said something about the doctor not being "qualified" even tho he was a real dentist.

This is an interesting question. According to EDD's regulations, the medical provider must complete and sign the medical certification portion of the DE 2501 claim form. The provider needs to be licensed/certified by the state where they practice, but there's nothing explicitly prohibiting foreign providers. However, I've worked with clients on similar cases, and there are a few practical challenges: 1. The foreign doctor must complete the standard EDD medical certification form (not their own country's equivalent) 2. All documentation must be in English or professionally translated 3. The doctor must include their medical license number and contact information 4. EDD may take longer to verify foreign credentials 5. You'll likely need to provide additional documentation about the medical necessity of the procedure I'd recommend having your US primary care doctor co-sign or provide supplemental documentation supporting the medical necessity of the procedure. This gives EDD a US-based medical provider they can easily contact if needed.

Just want to add my 2 cents - I had a hysterectomy in Canada (I live near the border) and EDD approved my claim, but it took FOREVER. They kept asking for more documentation and called my doctor multiple times. Ended up taking 6 weeks to get my first payment when it should have been like 2 weeks. Super stressful waiting that long with no income!

I work in HR and have helped employees navigate this exact situation. The key is preparation. Here's what you need: 1. Have your Mexican surgeon complete the medical portion of the DE 2501 form - make sure they include their medical license number and contact details 2. Get a certified English translation of any supporting documents not in English 3. Ask your PCP to write a letter confirming the medical necessity of the procedure (mention the rashes and back pain specifically) 4. File your claim online through SDI Online as soon as possible after surgery 5. Keep copies of EVERYTHING The big issue isn't usually the foreign doctor - it's proving medical necessity for what EDD might view as cosmetic surgery. That's why documentation from your regular doctor about the skin issues is crucial.

Good luck trying to talk to anyone at EDD about this beforehand! I spent 3 WEEKS trying to get someone on the phone about my claim. Finally used a service called Claimyr (claimyr.com) that got me through to a real EDD rep in 20 minutes. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd Worth it when you need answers about something complicated like foreign doctors. The rep I talked to said they do accept foreign providers but they have extra verification steps.

wait I'm confused... if the surgery is elective why would they pay disability?? I thought disability was only for like if you get hurt at work or have a baby

I've been through this nightmare with EDD. Even with perfect documentation, they'll probably deny your claim initially because it's a foreign doctor AND elective surgery - double red flags for them. Be prepared to appeal and provide mountains of medical records. They forced me to see their own doctor for a second opinion before they would pay my claim for surgery I had in Thailand. The whole system is designed to wear you down so you'll give up. If you're counting on this money, have a backup plan because it might take MONTHS to get approved.

One more important tip: make sure your employer fills out their portion of the DE 2501 form BEFORE you leave for Mexico. You don't want to be trying to coordinate that while you're recovering abroad. Also, double-check that your Mexican surgeon knows exactly how to complete the medical certification - any mistakes could cause significant delays.

Congrats on the weight loss!! I lost 130lbs a few years ago and also had the extra skin issues. It's crazy how insurance considers it "cosmetic" when it causes actual medical problems. I didn't have the surgery yet (saving up) but I'm curious how your experience goes. Please update us after!

I went through something similar with EDD for surgery in Costa Rica back in 2022. The foreign doctor issue is definitely manageable, but you need to be super organized about it. A few things that helped me: - I had my surgeon's office translate ALL documents into English before I even left the country (don't rely on Google Translate - get certified translations) - Made sure my surgeon understood they needed to use the exact wording from the DE 2501 form when describing my disability and work restrictions - Got a letter from my US doctor beforehand stating the surgery was medically necessary (sounds like you have legitimate medical reasons with the rashes and back pain) The whole process took about 4 weeks for approval, which wasn't too bad. The key was having everything perfectly documented upfront. EDD seems to approve foreign claims when all the paperwork is correct - they just scrutinize it more heavily. One warning though: make sure your surgeon gives you VERY specific work restrictions (like "no lifting over 5 pounds, no bending, no standing for more than 30 minutes at a time"). Vague restrictions like "light duty" can cause problems.

This is super helpful info! I'm dealing with a similar situation - planning surgery abroad and worried about the EDD approval process. Your point about getting certified translations done beforehand is smart - I hadn't thought about that timeline issue. Did you file your claim immediately when you got back to the US, or did you wait until you had all the translated documents? I'm trying to figure out the best timing to minimize any delays in getting benefits started. Also, when you say "certified translations" - did you use a specific service or just any professional translator? I want to make sure I get the right kind that EDD will accept.

Adding to what others have shared - I'm a benefits coordinator and have helped several employees navigate SDI claims for procedures done abroad. The foreign doctor aspect is definitely workable, but here are some additional considerations: 1. **Documentation timeline**: Start gathering your medical records showing the necessity (photos of rashes, dermatologist notes, etc.) NOW. EDD loves a clear medical history trail. 2. **Banking considerations**: Make sure your direct deposit info is current before you leave. International travel can sometimes trigger bank security holds that could delay your first payment. 3. **Communication plan**: Have someone stateside who can check your mail and handle any EDD correspondence while you're recovering in Mexico. They sometimes send time-sensitive requests. 4. **Recovery documentation**: Ask your surgeon to provide detailed daily restrictions for your entire recovery period, not just "8 weeks off work." EDD wants to see progression like "weeks 1-2: complete bed rest, weeks 3-4: limited walking," etc. The medical necessity angle is your strongest argument here - excess skin causing rashes and back pain is legitimate medical treatment, not cosmetic surgery. Document everything and you should be fine!

This thread is super helpful! I'm not dealing with surgery abroad myself, but I wanted to add something I learned when my sister had complications with her SDI claim last year. Make sure you understand EDD's "good cause" rules for any delays in filing. If there are any issues with getting your paperwork from Mexico (mail delays, translation issues, etc.), you can still file a late claim if you have "good cause" for the delay. But you need to document WHY there was a delay. Also, keep detailed records of all your communication attempts with EDD - dates, times, who you spoke with, reference numbers. If you end up needing to appeal anything, this documentation becomes really important. One last thing - consider asking your Mexican surgeon if they've worked with US disability claims before. Some medical tourism facilities are familiar with US insurance/benefits requirements and might have processes in place to help with the paperwork. Could save you some headaches! Good luck with everything! The weight loss journey is tough enough without having to worry about bureaucracy on top of it.

I'm new to this community but wanted to share something that might help! My cousin went through a similar situation with EDD for surgery in Guatemala last year. One thing that really helped her case was getting a pre-authorization letter from her insurance company (even though they didn't cover it) stating that the procedure was "medically necessary" - apparently EDD gives a lot of weight to insurance company medical determinations. Also, she mentioned that timing the surgery during a slower period at work helped with her employer documentation. Since you're planning for July 2025, you might want to coordinate with your HR about scheduling it when it would cause the least disruption to your team. Employers are sometimes more supportive with the paperwork when they feel like you're being considerate about timing. The excess skin issue after major weight loss is definitely a legitimate medical concern - I've seen friends struggle with infections and mobility issues from it. Document everything related to the physical problems it's causing you between now and surgery. The more medical evidence you have of it impacting your daily life and work, the stronger your case will be. Wishing you all the best with both the surgery and the SDI process! This community seems really knowledgeable about navigating EDD's requirements.

I haven't dealt with foreign surgery claims personally, but I work for a large employer in California and have seen this situation come up a few times with our employees. One thing I'd strongly recommend is contacting EDD's Disability Insurance branch directly before you travel - they have a specific unit that handles complex cases like foreign medical procedures. From what I've observed, the key factors that seem to make or break these claims are: 1. Having crystal clear medical necessity documentation (sounds like you have this with the rashes and back pain) 2. Making sure your Mexican surgeon understands they need to complete the DE 2501 form exactly as written - no substitutions or equivalent forms 3. Getting your employer's portion completed before you leave the country The employees who ran into problems were usually those who tried to figure it out after the fact. The ones who did their homework beforehand and got pre-approval guidance from EDD had much smoother experiences. Also, since you mentioned you have family in Mexico who can help with recovery - make sure they understand they might need to help coordinate any follow-up documentation requests from EDD while you're still recovering. Having a support system there who can handle administrative tasks could be really valuable. Good luck with your surgery! The fact that you're planning this far ahead shows you're taking the right approach.

I went through a very similar situation last year with EDD for panniculectomy surgery I had done in Tijuana after losing 150+ pounds. The excess skin was causing constant infections and making it impossible to exercise or even wear normal clothes comfortably. A few things that really helped my case get approved: **Before surgery:** - Got detailed documentation from my dermatologist about the recurring skin infections and photographs showing the medical issues - Had my PCP write a letter explicitly stating the procedure was "medically necessary" for infection control and mobility - Called EDD ahead of time and spoke with a supervisor who walked me through exactly what documentation they'd need from a foreign provider **For the Mexican surgeon:** - I brought printed copies of the DE 2501 form and highlighted exactly which sections they needed to complete - Made sure they included very specific work restrictions with timeline progressions - Had them provide their Mexican medical license number and contact information in English - Got everything notarized at the US Consulate while I was still in Mexico **The result:** My claim was approved in about 3 weeks with no issues. I think the key was having that US medical documentation backing up the necessity, plus being super thorough with the foreign doctor's paperwork. Total cost for translations and notarization was around $200, but it was absolutely worth it for peace of mind. Feel free to DM me if you want more specific details about the process!

I'm in a similar boat planning surgery abroad for medical reasons! This thread is incredibly helpful - I had no idea about the US Consulate notarization option or that EDD had a specific unit for complex foreign cases. Quick question for those who've been through this: did anyone have issues with their employer being supportive of the foreign surgery aspect? I'm worried my HR department might be hesitant to complete their portion of the DE 2501 if they think the surgery seems "sketchy" for being done outside the US, even though it's for legitimate medical reasons. Also, @Avery Flores - congrats on the amazing weight loss! It's frustrating how the medical system treats the aftermath of such a positive health change as "cosmetic" when you're dealing with real physical problems. Sounds like you're doing all the right research ahead of time though!

I'm a newcomer here but this thread is incredibly informative! I'm actually considering bariatric surgery myself and hadn't even thought about the potential SDI implications for dealing with excess skin later on. @Avery Flores - first off, huge congratulations on your weight loss journey! 180lbs is absolutely incredible and you should be so proud of that achievement. Reading through everyone's advice, it seems like the key themes are: 1) thorough documentation from US doctors about medical necessity, 2) making sure your Mexican surgeon completes the EDD forms exactly as required, 3) getting certified translations done properly, and 4) contacting EDD's specialized unit beforehand. One thing I'm curious about - has anyone dealt with the situation where you might need follow-up care once you return to the US? Like if there were complications or you needed additional medical attention from a US doctor, would that affect your SDI claim in any way? I'm wondering if it's worth establishing a relationship with a US plastic surgeon beforehand, even if you're not using them for the primary procedure. This community is amazing - so much practical, real-world advice that you just can't get anywhere else. Thanks to everyone sharing their experiences!