EDD SDI reaching 52-week limit with ongoing medical issues - options after benefits end?

Unfortunately once you hit the 52-week maximum for SDI, that's it for that condition. You can only start a new SDI claim if you have a completely different medical condition that prevents you from working. If your current condition continues, you won't be eligible for a new claim. As for your LTD question - your employer's Long Term Disability insurance will likely offset (reduce) your benefit by the amount you receive from Social Security retirement. Check your LTD policy carefully, but most policies have a Social Security offset clause that applies to both SSDI and regular Social Security retirement benefits.

my cousins husband had something similar happen last yr!!! he got to the end of benefits but still was sick and his dr tried to file a new claim but EDD denied it saying it was related to same medical issue. they ended up having to sell their second car to make ends meet until he got approved for ssdi which took FOREVER. so anoying how they just cut you off even when yr still sick

You need to look into applying for SSDI immediately if you haven't already. Unlike regular Social Security retirement, SSDI is specifically for people who become disabled before retirement age and can't return to work. The approval process takes MONTHS (sometimes over a year), so start now! Regarding the LTD through your job - yes, it will almost certainly reduce your benefit by whatever you get from regular Social Security. Read your policy carefully because most employer LTD plans have a "coordination of benefits" clause that reduces your LTD payment by the amount you receive from Social Security (whether retirement or disability). Source: went through this whole mess in 2023 when my SDI ran out.

Just wondering - have you talked to your doctor about whether there's ANY chance you could do some kind of modified work? Even if it's just a few hours a week in a totally different capacity? Sometimes EDD will approve partial disability if you can work at least a little bit. Might be worth asking about.

I've been trying to reach an EDD representative for WEEKS about a similar situation and keep getting disconnected or stuck on hold forever. Finally tried using Claimyr (claimyr.com) and they got me connected to an EDD rep in about 20 minutes. The rep explained that while I couldn't file a new claim for the same condition, I could potentially qualify for different programs. Check out their video demo if you want to see how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd Definitely worth it because the EDD rep actually took time to explain all my options rather than me just guessing.

The rules about SDI 52-week limits are RIDICULOUS!!! People don't just magically get better when the calendar says 52 weeks. The whole system is broken. What are people supposed to do when they're still sick?? The government doesn't care at all about people with chronic conditions.

One option you might want to explore is California's State Disability Insurance Elective Coverage (DIEC) program. It's typically for self-employed people, but in some cases, it can provide coverage when regular SDI runs out. There are specific eligibility requirements, so you'd need to contact EDD directly to see if this could be an option for you. Also, check if your employer has any other disability programs or if there are any union benefits you might qualify for. Some employers offer supplemental disability insurance that can kick in after SDI ends.

To answer your original question about filing a new claim after 52 weeks - the rule is that you need to have returned to work for at least 60 days AND have a new disability (or the same disability with a period of recovery) to qualify for a new claim. If you haven't returned to work at all, then you wouldn't be eligible regardless of whether it's the same condition or a new one. The system is designed with the assumption that disability is temporary, which unfortunately doesn't work for people with chronic or progressive conditions. For your Social Security question - check your LTD policy, but most will offset (reduce) your LTD benefit by the amount of Social Security you receive. They typically don't care whether it's SSDI or regular retirement SS.

my friend had her doctor write that she had a NEW diagnosis even tho it was kinda related to her old one and she got approved for a new claim!!! might be worth asking your doctor if theres any way to classify your condition differently????

Have you considered applying for CalFresh or other assistance programs while you figure out your next steps? They won't replace your income but might help with some expenses in the transition period. There's also General Assistance through your county, though the amounts are pretty low.

I'm in a similar situation and just wanted to share what I learned from my disability attorney. Since you're already receiving regular Social Security retirement, you actually CAN'T apply for SSDI - you can only get one or the other, not both. However, you might want to look into SSI (Supplemental Security Income) if your total income falls below certain thresholds after your SDI ends. Also, regarding your LTD policy - many have a "pre-existing condition" clause that could affect coverage if your disability started before you enrolled in the plan. Make sure to check that language carefully. Some policies also have different offset rules for Social Security retirement vs. SSDI, so definitely read the fine print. One more thing - if you haven't already, document EVERYTHING with your doctor about how your condition has worsened or changed. Even if you can't get a new SDI claim, having detailed medical records will be crucial for any other benefits you apply for.

I went through something very similar last year when my SDI was about to hit the 52-week limit. Here's what I learned that might help: 1. **Gap coverage is crucial** - Start applying for any other benefits NOW, not when SDI ends. The approval processes can take months and there's often no retroactive coverage. 2. **SSI vs SSDI confusion** - @Ethan Anderson is absolutely right. Since you're already getting regular Social Security retirement, you can't get SSDI. But SSI might be possible if your total monthly income (including your SS retirement) falls below the federal limit (around $914/month in 2024). 3. **LTD timing matters** - Most employer LTD policies require you to apply within a certain timeframe (often 180 days) from when you become disabled, not from when other benefits end. Check your policy immediately to make sure you haven't missed any deadlines. 4. **Document everything** - Keep detailed records of how your condition has progressed/worsened. This helped me when I had to explain to various agencies why I still couldn't work after a full year. The whole system really is frustrating when you're dealing with chronic conditions that don't fit the "temporary disability" model. Hang in there and start those applications ASAP!

I'm so sorry you're going through this - the 52-week cliff is one of the most stressful aspects of the SDI system. I went through something similar about 6 months ago and wanted to share a few things that might help: **Immediate action items:** - Contact your county's social services office about General Assistance and CalFresh (as @Andre Dubois mentioned) - do this NOW, not after benefits end - If you have any retirement accounts (401k, IRA), look into hardship withdrawals as a bridge option - Check if your utility companies have medical baseline programs or payment assistance for disabled customers **Something I wish I'd known earlier:** Some people qualify for California's In-Home Supportive Services (IHSS) program if their condition affects daily living activities. It's not income replacement, but it can provide some financial assistance and services. **LTD reality check:** Most employer plans I've seen do offset Social Security retirement benefits, but the good news is that your combined income (LTD + SS retirement) is usually designed to replace 60-70% of your pre-disability income, which might still be better than just SS retirement alone. The waiting and uncertainty is absolutely brutal, but you're asking the right questions and getting good advice here. Start those applications for everything you might qualify for - worst case they say no, but at least you'll know you tried everything available to you.

I'm really sorry you're facing this situation - the 52-week limit feels so arbitrary when you're dealing with a condition that's actually gotten worse, not better. One thing I wanted to add that I haven't seen mentioned yet: if your condition has significantly worsened or developed new symptoms since your original SDI claim, you might want to ask your doctor about whether this could qualify as a "new and distinct" disability. While EDD is strict about this, sometimes conditions that start as one thing can evolve into something different enough to potentially qualify for a separate claim (though you'd still need that 60-day return-to-work period that others mentioned). Also, since you mentioned you're already receiving regular Social Security retirement, have you looked into whether you might qualify for Medicare if you're not already enrolled? Some people don't realize they might be eligible earlier than 65 if they have certain qualifying disabilities, and having better healthcare coverage could be crucial as you navigate this transition. The timing pressure is real - June will be here before you know it. But it sounds like you're getting some really solid advice in this thread about SSI, LTD coordination, and assistance programs. Document everything with your doctors and start those applications now rather than waiting. You've got this, even though it feels overwhelming right now.

I'm so sorry you're going through this - the timing stress of hitting that 52-week limit while still dealing with worsening symptoms is incredibly difficult. Based on everything I'm reading here, it sounds like your best immediate options are: 1. **Apply for SSI right away** - Since you're already on Social Security retirement, SSDI isn't an option, but SSI might be if your total monthly income falls below the federal limits 2. **File that LTD claim ASAP** - Check your policy deadlines immediately. Most require filing within 180 days of becoming disabled, not from when other benefits end 3. **Start county assistance applications now** - CalFresh, General Assistance, and potentially IHSS if your condition affects daily activities The gap between when SDI ends and other benefits potentially start is the scariest part, but starting these applications now gives you the best chance of minimizing that gap. One thing I'd add - if you have any employee assistance programs through work, they sometimes have social workers who can help navigate all these different benefit systems. It might be worth checking if that's available to you. Hang in there. June feels soon but you still have time to get these applications rolling.

I'm really sorry you're dealing with this stressful situation - hitting the 52-week SDI limit while your condition has actually worsened must feel incredibly unfair. From reading through all the responses here, it sounds like you've gotten some excellent advice about your immediate next steps. I wanted to add one thing that might be helpful: consider reaching out to a disability attorney or advocate for a consultation. Many offer free initial consultations and can help you navigate the complex interactions between different benefit systems (SSI, LTD, Social Security retirement, etc.). They often know about lesser-known programs or appeal strategies that might apply to your specific situation. Also, since your condition has worsened rather than improved, make sure your medical team is thoroughly documenting not just your current limitations, but specifically how your functional capacity has declined over the past year. This type of detailed progression documentation can be crucial for any benefit applications you file. The timeline pressure is real, but you're being proactive by asking these questions now rather than waiting until the last minute. That puts you ahead of many people who don't realize they need to start planning for this transition months in advance.

I'm so sorry you're facing this incredibly stressful situation. Reading through your post and all the responses, it's clear you're getting some really valuable advice here about SSI, LTD coordination, and assistance programs. One thing I wanted to add that I haven't seen mentioned - have you looked into whether your state has any emergency financial assistance programs for people transitioning between disability benefits? Some states have short-term bridge programs specifically designed to help people during gaps in coverage. It might be worth calling 211 (the general helpline for social services) to ask about any emergency assistance programs in your area. Also, since you mentioned your condition has actually gotten worse over the year, I'd strongly encourage you to ask your doctor to write a detailed letter documenting not just your current limitations, but specifically how your functional capacity has declined since your original disability onset. This kind of documentation showing deterioration rather than improvement could be really important for any benefit applications or appeals you might need to file. The 52-week cliff is genuinely one of the most poorly designed aspects of the disability system - you're definitely not alone in feeling frustrated by how arbitrary it feels when dealing with chronic or progressive conditions. But you're asking all the right questions and getting great advice here. Start those applications now and give yourself the best chance of minimizing any gap in coverage.