EDD disqualified my SDI claim despite having doctor's note - what am I missing?
I'm completely lost and frustrated with my disability claim situation. I filed for SDI about 3 weeks ago after my doctor put me on medical leave for severe anxiety and depression. Today I checked my account and it says DISQUALIFIED. No explanation, no letter, nothing! I have all my paperwork - my doctor submitted the certification form electronically the same day I filed. I definitely wasn't looking for work since I'm literally unable to work right now (that's the whole point of disability!). My doctor said I should be covered for at least 12 weeks, but EDD apparently disagrees. Has anyone dealt with this? What could be the reason they're denying me when I have proper medical documentation? I'm freaking out because I need this income to survive while I'm getting treatment.
24 comments
Sophie Hernandez
There could be several reasons why you got disqualified. Did you check if your doctor filled out the medical certification form correctly? Sometimes they miss sections or don't provide enough details about your condition. Another possibility is that you might have accidentally answered something incorrectly on your application. Did you have any gaps in employment before filing? Sometimes EDD disqualifies claims if you weren't actively working before becoming disabled.
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Emily Thompson
•I'm pretty sure my doctor filled everything out right, but I'll double-check with her office tomorrow. I was definitely employed full-time right up until my disability started. No gaps at all. I'm wondering if maybe I answered something wrong on the application, but I was so careful when filling it out! Could it be because this is my first time filing for disability? Do they sometimes reject first-time claimants?
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Daniela Rossi
the same EXACT thing happened to me last month!!! turns out my dr put the wrong diagnosis code on the form. call ur dr first and ask them to check if they made any mistakes on the form.
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Emily Thompson
•Omg thank you, I'll definitely call them first thing tomorrow. Did your doctor have to submit a corrected form? How long did it take to fix?
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Daniela Rossi
•yea they had to submit a corrected form. took like 10 more days to get approved after that. such a pain!
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Ryan Kim
Check your EDD SDI account inbox or your physical mail. There should be a Notice of Determination explaining exactly why you were disqualified. The disqualification reason is crucial because it determines what your next steps should be. Common disqualification reasons include: 1. Insufficient wage credits in your base period 2. Incomplete medical certification 3. Late filing (beyond 49 days from disability onset) 4. Conflicting information between your application and doctor's certification 5. Pre-existing condition issues Don't panic yet - many disqualifications can be appealed with the right documentation. But first, you need to know the specific reason.
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Emily Thompson
•Thank you for this detailed explanation. I checked my online inbox and physical mail and still nothing explaining why. Would calling EDD be the fastest way to find out? I'm worried about the appeal deadline if I can't figure out why they disqualified me.
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Zoe Walker
EDD is THE WORST!!!! I had mental health disability claim last year and they denied me too at first because they said my condition wasn't "verifiable" enough. Like WTF does that even mean??? My therapist and psychiatrist both submitted paperwork! Had to fight them for WEEKS to get it approved. The system is BROKEN!!!!
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Emily Thompson
•That's so frustrating and scary to hear. Mental health conditions are real disabilities! Did you have to get additional documentation? I'm worried they're discriminating against mental health claims.
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Zoe Walker
•Yeah I had to get my psychiatrist to write a more detailed letter explaining exactly how my condition prevented me from working. Also had to submit my medication history. It's like they assume we're all lying about mental health. FIGHT THEM ON THIS!!!
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Elijah Brown
I work at a doctor's office that handles lots of disability forms, and we see this happen frequently. The most common issues with mental health claims are: 1. The doctor didn't specify clear functional limitations (how your condition prevents specific job duties) 2. The estimated recovery time wasn't clearly stated 3. Treatment plan wasn't detailed enough 4. Missing documentation of ongoing care Call your doctor's office and ask them to review what was submitted. They might need to provide additional documentation to support your claim. Also, did you file for SDI or for Paid Family Leave? They're different programs, and people sometimes file for the wrong one accidentally.
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Emily Thompson
•I definitely filed for SDI, not PFL. I'll call my doctor's office tomorrow and specifically ask about those four points you mentioned. Thank you so much for the insider perspective! Do you think it would help if I got a more detailed letter from my therapist too? I see both a psychiatrist (who completed the disability form) and a therapist weekly.
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Elijah Brown
•Yes, additional documentation from your therapist would definitely strengthen your case, especially if they can detail how your symptoms impact your ability to perform your specific job functions. Make sure both providers are consistent in their assessment of your condition and limitations. When you appeal, submit everything together as a comprehensive package.
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Maria Gonzalez
Have you tried calling EDD directly? You really need to find out the specific reason for disqualification before you can fix it. I had to call about 50 times before I got through when I had an issue with my claim last year. So frustrating!
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Emily Thompson
•I tried calling a few times today but kept getting the message that their call volume is too high. I'll keep trying tomorrow. Did you just keep hitting redial until you got through?
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Natalie Chen
After dealing with a similar situation last month, I discovered Claimyr (claimyr.com) which helped me get through to an actual EDD representative in about 20 minutes instead of calling for days. They have a service that basically calls EDD for you and then connects you when they reach an agent. Saved me so much stress when my claim was incorrectly disqualified. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd Once I got through, the rep explained exactly why my claim was flagged (doctor used wrong date codes) and I was able to get it fixed that same day. For mental health claims especially, talking to an actual person makes a huge difference.
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Emily Thompson
•Thank you! I've never heard of this service before but I'm definitely going to check it out. At this point I'd try anything to get this resolved quickly. Did you find the EDD rep was able to see all the details about why your claim was disqualified?
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Natalie Chen
•Yes, the rep had access to all the notes on my claim including exactly what was flagged in the system. She could see that my doctor had put an incorrect work history date that conflicted with what I submitted. Once I explained the situation, she created a note in the system and told me exactly what additional documentation I needed to submit. Saved me from weeks of guessing!
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Ryan Kim
One more thing to check - make sure you're not confusing a "pending" status with "disqualified." They're very different. Sometimes the SDI Online system shows a pending status that people misinterpret. A true disqualification will specifically say "disqualified" or "denied" and generate a formal Notice of Determination. If you've been truly disqualified: 1. You have 30 days from the date on the Notice to appeal 2. Appeals can be submitted online through your SDI account 3. You'll need to include any supporting documentation 4. Be specific about why you believe the decision is incorrect Also, while your appeal is pending, continue with your treatment plan and keep documentation of everything. This will be important if you need to provide additional evidence.
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Emily Thompson
•It definitely says "disqualified" in red on my account summary page. I've checked every section of the website and my mail, and still no Notice of Determination explaining why. I feel like I'm in limbo. I'll try calling again tomorrow and check with my doctor too. Thank you for the appeal information - at least I know what to do once I figure out the reason!
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Santiago Martinez
did u check ur spam folder? sometimes edd emails go there.
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Emily Thompson
•I just checked and nothing there either. I'm beginning to think they haven't actually sent the notice yet even though the status changed to disqualified on my account. The whole system is so confusing!
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Sophie Hernandez
Let us know what you find out! I'm dealing with an EDD issue too (different situation) and it helps to hear how others resolve their problems.
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Emily Thompson
•I will definitely update once I figure this out. Seems like everyone has EDD horror stories!
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