< Back to California Disability

Katherine Ziminski

Can I get EDD SDI benefits for injuries that happened outside of work?

So I slipped and fell in my kitchen last weekend and now my doctor is saying I need to stay off my feet for at least 6 weeks because of a bad ankle fracture. I've never filed for disability before and always thought it was just for work injuries? My friend says I might qualify for EDD SDI even though this happened at home. Is that true? Do I need to have some special insurance to qualify? My employer seemed confused when I asked about it and just kept talking about workers comp which obviously doesn't apply here. Any advice would be really appreciated!

Noah Irving

•

Yes! SDI is absolutely available for non-work injuries and illnesses. Unlike workers' comp (which is only for injuries that happen at work), State Disability Insurance covers ANY medical condition that prevents you from doing your regular work, regardless of where the injury happened. As long as you've paid into SDI through payroll deductions (check your paystub for "CASDI") and have a doctor who will certify your disability, you should qualify. You'll need to file a DE 2501 claim and have your doctor complete their portion. Apply online through SDI Online for fastest processing.

0 coins

Thank you SO MUCH for clarifying this! I just checked my paystub and I do see the CASDI deduction. Going to talk to my doctor tomorrow about filling out their part. Really appreciate the help!

0 coins

Vanessa Chang

•

i broke my leg skiing last year, got SDI no problem

0 coins

That's super reassuring to hear! Did you apply online or use the paper forms?

0 coins

Vanessa Chang

•

online way faster

0 coins

Madison King

•

Be prepared for the waiting period though! There's a mandatory 7-day waiting period before benefits start, and then it usually takes them at least 2 weeks to process the claim after you submit everything (if there are no issues). So financially plan for at least 3 weeks with no income, probably longer honestly. And they'll only pay you for 52 weeks MAXIMUM but that's only if your doctor keeps certifying that you can't work. Most claims are shorter.

0 coins

Oh wow, I didn't know about the waiting period. That's going to be rough, but better than nothing I guess. Thanks for the heads up!

0 coins

Julian Paolo

•

Make sure when your doctor fills out their part they are VERY specific about your work restrictions and WHY you can't do your normal job. My claim got delayed for weeks because my doctor just wrote "patient needs time off" instead of detailing exactly what my limitations were. The EDD wants to know specifically why you can't perform your "regular or customary work.

0 coins

That's really helpful advice, thank you! I'll make sure to talk to my doctor about being very specific with the limitations. I definitely don't want any delays.

0 coins

Ella Knight

•

THE EDD IS THE WORST!!! I had a non-work injury last year and they denied my claim saying I didn't provide enough medical evidence even though my doctor sent EVERYTHING they asked for. Then they "lost" my appeal paperwork TWICE!!! And you can NEVER get anyone on the phone to explain anything. The whole system is designed to make you give up!!!

0 coins

I had the same issue trying to reach EDD about my claim status. Finally used a service called Claimyr (claimyr.com) that got me connected to an actual EDD representative in about 20 minutes instead of spending days calling. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd. Totally worth it when you're desperate to get your claim issues resolved.

0 coins

Ella Knight

•

OMG thank you for this!! Will check it out next time I need to deal with them!

0 coins

Just to add some clarification here: California SDI is specifically designed to cover both non-occupational injuries (like what happened to you) and illnesses. The confusion happens because many people mix up Workers' Compensation (for work injuries) with State Disability Insurance (for any medical condition regardless of cause). Your SDI benefit amount will be approximately 60-70% of your wages (depending on your income level) up to the maximum benefit amount. Make sure you have your doctor submit their certification promptly after you file your claim online through SDI Online. The sooner everything is submitted completely, the faster your claim will be processed.

0 coins

Thank you for the additional details! Knowing I'll get around 60-70% of my wages is really helpful for planning. I'm going to apply online tonight and then follow up with my doctor tomorrow.

0 coins

Jade Santiago

•

wait im confused does this mean i could get disability for my surgrey last month?? it wasnt work related but i was out for 3 weeks. can i still apply or is it too late??

0 coins

Noah Irving

•

You can file a claim up to 49 days after your disability begins, so you might still be within the window to apply for those 3 weeks! You should apply ASAP if you're still within that timeframe. Even if you're already back at work, you can still receive benefits for the time you were unable to work.

0 coins

Update: I filed my claim online yesterday and my doctor submitted their certification this morning! The SDI Online system was actually pretty straightforward. Now it's just waiting to see if it gets approved. Thanks everyone for the advice and help!

0 coins

That's great! Just make sure you check your SDI Online account regularly for any messages or requests for additional information. Sometimes they need clarification on things, and if you don't respond promptly, your claim could be delayed. Since this is a straightforward fracture with clear work restrictions, you should have a relatively smooth process compared to some more complex medical conditions.

0 coins

Will do! I've bookmarked the website and will check it daily.

0 coins

Great to see you got everything submitted so quickly! Just wanted to add one more tip - if you need to extend your disability beyond the initial 6 weeks your doctor estimated, make sure to have them submit a continuation claim (DE 2525C) before your current certification period expires. Don't wait until the last day because there can't be any gaps in coverage. Also keep all your medical records and documentation organized in case EDD requests additional proof later. Hoping for a smooth approval process for you!

0 coins

Sasha Reese

•

This is such valuable info about the continuation claims! I had no idea about the DE 2525C form or that there can't be gaps in coverage. I'm definitely going to save this comment and keep it handy in case I need to extend beyond the 6 weeks. Really appreciate everyone in this community sharing their experiences - it's making this whole process so much less stressful!

0 coins

ThunderBolt7

•

As someone who's been through the SDI process a few times, I wanted to add that you should also notify your employer about your disability claim even though it's not work-related. They can't legally retaliate against you for filing, and some employers have supplemental disability policies that might provide additional benefits. Also, make sure you understand that SDI benefits are taxable income - they don't withhold taxes automatically, so you might want to set aside some money for tax season or request voluntary withholding when you file. The ankle fracture should be pretty straightforward for approval since it's an obvious physical limitation that prevents you from performing normal work duties. Good luck with your recovery!

0 coins

California Disability AI

Expert Assistant
Secure

Powered by Claimyr AI

T
I
+
20,087 users helped today