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Donna Cline

EDD denied SDI for school cafeteria worker during summer break - ADHD/anxiety child care options?

My wife's SDI claim was just denied and we're completely lost on what to do next. She works in a school cafeteria but is out of work during summer break (not technically laid off, just no hours until September). Our son has severe ADHD and debilitating anxiety that requires constant supervision - she can't work elsewhere during break because of his care needs. We filed for disability since she's essentially his full-time caregiver right now, with documentation from his psychiatrist about his condition. EDD denied the claim stating 'not eligible during normal school break period' but this doesn't make sense since it's about HER inability to work due to caregiving, not about school being closed. Has anyone successfully appealed something like this? What specific forms should we request? Any help appreciated - we're struggling financially and emotionally right now.

this isnt disability, you need to apply for PAID FAMILY LEAVE (PFL) not SDI. totally different program for caregivers. start over with the right form!

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Donna Cline

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Wait really? The doctor's office told us to file SDI since she's the one unable to work. Is PFL for caring for children too? I thought that was just for new babies.

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The previous comment is partially correct, but there's a bit more nuance here. Your wife needs to apply for Paid Family Leave (PFL), not State Disability Insurance (SDI). PFL is specifically for when you need time off work to care for a seriously ill family member, including children with serious health conditions like severe ADHD and anxiety disorders. However, there are a few important things to know: 1. PFL requires a medical certification from your son's doctor confirming his condition requires caregiving 2. School employees often have special rules regarding benefits during scheduled breaks 3. She'll need to have earned enough wages during the base period to qualify The denial you received is because SDI is for your own disability, not for caregiving. File a new claim through SDI Online but select the PFL option instead. Make sure your son's doctor completes form DE 2501F thoroughly explaining why his condition requires full-time supervision.

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Donna Cline

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Thank you so much for explaining this! His psychiatrist is very supportive so getting the documentation shouldn't be a problem. Do you know if the special rules for school employees still apply to PFL claims? That's what I'm worried about.

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Dylan Fisher

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I WENT THROUGH THIS EXACT NIGHTMARE last summer!!!! School cafeteria worker too (different district probably). EDD has these stupid "reasonable assurance" rules for school employees during breaks that make everything 10x harder. They denied my first PFL application too even though my daughter needed care. Had to appeal THREE TIMES and finally got approved in OCTOBER when school was already back!! The system is BROKEN for school workers!!

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Donna Cline

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Oh no, that sounds awful! Did you end up getting backpay for the summer months at least? We really can't wait until October...

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Dylan Fisher

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Yes got backpay eventually but had to max out credit cards waiting. The key was getting a lawyer to help with the appeal - cost $800 but worth every penny since we got about $6,700 in benefits. The "reasonable assurance" rule is supposed to be for unemployment not PFL but they apply it anyway unless you fight it.

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Edwards Hugo

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my sister works for a school too and she just applies for unemployment during summers instead of bothering with disability stuff. way easier

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Unfortunately, unemployment likely won't work in this situation. To qualify for unemployment, you must be able and available to accept work. Since OP's wife needs to provide full-time care for their child with special needs, she wouldn't meet that requirement. That's why PFL is more appropriate here since it's specifically designed for caregiving situations.

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Gianna Scott

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Have you tried calling EDD directly to speak with a representative? They might be able to guide you through the correct application process for your specific situation. I had a similar issue (though not school-related) and was able to resolve it by speaking directly with an EDD representative who explained exactly what I needed to do. I know getting through to EDD can be nearly impossible though! I used a service called Claimyr (claimyr.com) to connect with an EDD rep quickly instead of dealing with busy signals and disconnections for days. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd Once I got through to a real person, they helped me understand which program was right for my situation and how to properly file the claim with all required documentation.

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Donna Cline

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Thanks for the tip! I've been trying to call for days and just keep getting the automated message that call volume is too high. I'll check out that service - at this point I'm willing to try anything to get this sorted out.

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Alfredo Lugo

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You mentioned your son has ADHD and anxiety - has he been assessed for regional center services? My daughter qualified and we get respite care hours that actually PAY my wife as his caregiver during summer. Might be another option to look into while you sort out the PFL situation. The intake process takes a while tho.

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Donna Cline

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We've been on a waiting list for assessment for about 4 months now. I didn't realize they could potentially pay for caregiving - that's really helpful to know! I'll follow up with them tomorrow to see where we are in the process.

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Sydney Torres

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I'm really confused by some of the advice here. PFL has a maximum of 8 weeks in a 12-month period. That won't even cover the whole summer break. And don't school cafeteria workers usually qualify for unemployment during scheduled breaks? Something doesn't add up in the advice you're getting.

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You raise good points. School employees with "reasonable assurance" of returning to work after scheduled breaks (like summer) typically don't qualify for unemployment during those periods under CA Education Code. The 8-week PFL limitation is also correct. The best approach here might be a combination of benefits and services: 1. PFL for 8 weeks of the break 2. Regional center services if the child qualifies (as mentioned by another commenter) 3. Possibly looking into In-Home Supportive Services (IHSS) if the child's condition is severe enough It's a complex situation that likely requires case-specific guidance from both EDD and potentially a benefits counselor familiar with special needs resources.

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did u try appealing the denial?? u have 30 days to do it!

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Donna Cline

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We just got the denial letter yesterday, so we still have time. I think based on the advice here we'll file for PFL instead of appealing the SDI denial since it sounds like that's the correct program anyway.

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Have you contacted your local Department of Rehabilitation? They might have resources for families with children who have disabilities including potential employment solutions that accommodate caregiving needs.

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Donna Cline

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UPDATE: I got through to EDD this morning using that Claimyr service someone suggested (took 20 minutes instead of days of trying). The rep confirmed I should withdraw the SDI claim and file for PFL instead. She also mentioned that school employees with "reasonable assurance" of returning DO face additional scrutiny but PFL can still be approved with strong medical documentation. My wife's starting the PFL application today and we've scheduled an appointment with a benefits counselor at the regional center next week to discuss additional options. Thank you all for the help and guidance! Will update when we hear about the PFL claim.

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That's great news! Make sure your son's doctor is very specific in the medical certification about why his condition requires full-time supervision and care. The more detailed, the better your chances of approval. Good luck!

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Dylan Fisher

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Fingers crossed it goes better for you than it did for me! Definitely push for expedited processing if possible.

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Sophia Clark

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So glad you were able to get through to EDD and get on the right track! Just wanted to add - when you're working with your son's psychiatrist on the medical certification, ask them to specifically mention things like safety risks, need for constant redirection, inability to be left alone, etc. EDD looks for concrete examples of why supervision is medically necessary, not just the diagnosis itself. Also, if your son has an IEP or 504 plan at school that documents his needs, include copies of those too - it helps show the consistency of his condition across different settings. Rooting for you both!

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Emma Olsen

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This is such helpful advice! I hadn't thought about including his school documentation but that makes perfect sense - it shows this isn't just a summer issue but an ongoing need for supervision. His IEP does have a lot of detail about his behavioral needs and safety concerns. Thank you for thinking of that! We'll definitely include copies when we submit the PFL application.

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