EDD denied start date of my surgery-related disability claim - what happens now?
I received this confusing notice from EDD about my SDI claim and I'm totally lost on what to do next: "Your first claim for Disability Insurance Benefits has been denied from 03/11/24 through 04/06/24. The beginning date (claim effective date) of your claim has been adjusted because: The beginning date cannot be more than 7 days before the first date you were examined by or under the care of a physician or practitioner. This determination is final unless you file an appeal within thirty (30) days from the mailing of this notification." The thing is, 3/11 was literally the day I had my knee surgery (which is why I'm temporarily disabled), so I was definitely under a doctor's care that exact day! I don't even see what date they've adjusted my claim to start. Do I need to appeal this? Reapply? Or just wait since they said they adjusted it themselves? I'm panicking because I really need this income while I recover. Help!
18 comments

Giovanni Ricci
This is actually a pretty common issue with EDD SDI claims. What the notice means is they're not denying your entire claim - just the starting date. Basically, EDD is saying that according to their records, your first documented doctor visit/care was later than 3/11, so they've moved your claim effective date forward to match that date (plus the 7-day waiting period all SDI claims have). You need to check your SDI Online account to see what new effective date they've given you. If it's only off by a few days, it might not be worth appealing. But if it's significantly later and you can prove you were under doctor's care on 3/11, then definitely appeal within that 30-day window.
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Amara Eze
•Thank you! I'll check my SDI Online account right now. If my doctor literally performed surgery on me on 3/11, would that count as being "under care"? Should I get them to submit some kind of additional documentation to prove the surgery date?
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NeonNomad
omg the EXACT same thing happened to me last year!!! i had shoulder surgery and they denied the first 2 weeks claiming my doctor didnt see me until later?? but he LITERALLY cut me open lol. turns out my doctor's office put the wrong date on the medical certification form. call your doctor and have them check what date they put on your form!!
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Amara Eze
•OMG that would explain it! I'll call my doctor's office tomorrow morning. Do you know if they can just submit a corrected form, or do I have to do a formal appeal?
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Fatima Al-Hashemi
What's happening here is a clerical issue. For SDI claims, there are two important dates: 1. The date you became disabled (your surgery date) 2. The date you were first examined/treated by your doctor for this condition If you had a consultation with your surgeon prior to the actual surgery date, that's technically when you were first "under care" for this condition. The system expects these dates to match up. Your doctor likely filled out the medical certification (DE 2501) with only the surgery date, not acknowledging the pre-surgical consultation. You have three options: 1. Appeal within 30 days (safest option) 2. Ask your doctor to submit an amended DE 2501 form with corrected dates 3. Accept the adjusted date if it's only off by a few days But check your SDI Online account first to see the actual adjusted date.
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Amara Eze
•This makes so much sense! I did have a pre-surgical consultation about 2 weeks before the actual surgery. Maybe that's what's causing the confusion. I'll check my SDI Online account to see the adjusted date and talk to my doctor about correcting the form. Thank you so much for explaining!
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Dylan Mitchell
just wait it out... they'll pay u eventually. EDD always does this kinda stuff
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Sofia Martinez
I had a NIGHTMARE trying to resolve a similar issue with my SDI claim last month. Spent literally 6 days trying to get through to an actual SDI rep by phone. Finally used a service called Claimyr (claimyr.com) that got me connected to an EDD agent in about 22 minutes. They have this demo video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd Once I actually spoke to someone, they explained that my doctor had entered the wrong date in the system, and the rep was able to notate my account while I had my doctor's office fax in a correction. Way easier than going through the formal appeal process.
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Amara Eze
•Thanks for the tip! I'll try calling them first, but if I can't get through I'll check out that service. Did they fix your issue right away once you got someone on the phone?
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Sofia Martinez
•The agent couldn't change it directly, but they noted my account and told me exactly what documentation was needed from my doctor. Once my doctor sent in the corrected form, it was fixed within 3 days. Much faster than the appeal process which can take weeks.
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Dmitry Volkov
THE SYSTEM IS BROKEN!!!! EDD denies EVERYTHING initially hoping you'll just give up and not appeal. They did this to my wife, my brother AND my neighbor all in the last year. It's all about DENYING benefits that we've PAID FOR through our taxes!!!!
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Giovanni Ricci
•That's not entirely accurate. They're not denying the entire claim, just adjusting the start date based on the information provided on the medical certification. It's often just a documentation issue that can be fixed.
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Dmitry Volkov
•Yeah right, keep believing that. My wife submitted ALL the correct documentation and they STILL denied her first week. When she appealed they magically found her paperwork was "correct all along" - SURE!!!
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Ava Thompson
This is why I always tell people to make copies of EVERYTHING you submit to EDD. Did you keep a copy of what your doctor submitted? My orthopedist gave me a copy of my disability form before they sent it in and that saved me when EDD tried to claim they had different dates.
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Amara Eze
•No, I didn't think to ask for a copy 😞 Lesson learned for next time. I'm going to call my doctor's office tomorrow to find out what dates they put on the form.
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Fatima Al-Hashemi
Update to my earlier comment: After reviewing your situation again, I want to clarify something important. If 3/11 was your surgery date, but you had pre-surgical consultations earlier, EDD might actually be correct in their adjustment. The SDI regulations state that benefits begin on the 8th day of disability (that's the waiting period), but the claim effective date can't be more than 7 days before you first saw a doctor for the condition. Example: If your first consultation for the knee issue was on 3/1, and your surgery was on 3/11, then the earliest your claim could be effective would be 2/23 (7 days before 3/1). But since your disability actually started on 3/11, that's when your 7-day waiting period would begin, making your benefits potentially payable from 3/18 onward. Check your online account to see the actual adjusted dates - this might all be working correctly.
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Amara Eze
•Thank you for this additional explanation! I checked my SDI Online account and it shows my claim is now effective from 3/18/24. My surgery was 3/11, and my first consultation for this knee issue was actually back in February, so I think they're calculating the 7-day waiting period starting from my surgery date. That makes sense now. I don't think I need to appeal after all!
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Keisha Williams
I'm glad you were able to check your online account and everything is making sense now! Just wanted to add that even though your claim is effective from 3/18, you should still keep all your documentation from the surgery and consultations organized in case EDD requests anything else later. Also, make sure to submit your continued claim forms (DE 2501C) on time every two weeks to keep your benefits flowing smoothly. Recovery from knee surgery can take a while, so don't rush back to work before you're medically cleared. Take care of yourself!
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