EDD wrongly denying my PFL claim because they think I'm eligible for regular disability - help!
I'm so frustrated with the California EDD right now! I applied for Paid Family Leave in January 2025 after my daughter was born (8 weeks of baby bonding). Initially everything seemed fine, but then 3 months later, they sent me a denial letter saying I should have applied for State Disability Insurance (SDI) instead of PFL. But that makes no sense - I wasn't disabled, I was taking care of my newborn! I immediately appealed their decision and submitted all my documentation again (birth certificate, employer verification, etc). They overturned the decision and I started receiving payments. But then LAST WEEK they sent ANOTHER denial letter saying I don't qualify for PFL for the last 3 weeks of my claim because I should have been on regular disability?? I spoke with several EDD reps when I first applied who confirmed PFL was the correct benefit for my situation. I've already filed another appeal but I'm worried they'll deny me again. The hearing is scheduled for next month. What can I say/do to fight this ridiculous back-and-forth? Has anyone successfully dealt with EDD constantly switching their reason for denial?
19 comments
Sean Murphy
OMG this EXACT same thing happened to me!! The EDD is such a mess with these claims. They kept saying I needed to be on disability instead of PFL, but I was taking care of my sick mother not recovering from childbirth! I had FOUR appeals before they finally got it right. The system is completely broken and they're just trying to deny valid claims to save money. Makes me so ANGRY!!
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Anastasia Popov
•Four appeals?! That's insane. Did you have to have a hearing each time? I'm dreading going through this process over and over.
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Zara Khan
I think I can explain what's happening here. There's often confusion between SDI and PFL because they're administered by the same department but are distinct benefits. SDI is for your own medical condition (including recovery from childbirth), while PFL is for bonding with a new child or caring for a family member. What's likely happening is that the EDD computer system is flagging your claim because they think you should be on SDI for postpartum recovery first, then transition to PFL for baby bonding. Typically, birth mothers file for SDI for 6-8 weeks after delivery (depending on delivery type), then transition to PFL for the 8 weeks of bonding time. For your appeal, you need to clearly explain whether you've already received SDI for postpartum recovery. If you did, bring documentation showing when that ended and when your PFL claim started. If you didn't receive SDI (perhaps you're not the birth mother or you're beyond the postpartum period), you need to clearly explain that in your appeal.
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Anastasia Popov
•This makes so much sense, thank you! I did actually receive SDI for 6 weeks after delivery (had a normal birth in December), and filed for PFL in January when my SDI ended. I have all the documentation showing the transition. I think the EDD computer system might be confused because there was a weekend gap between when my SDI ended and my PFL started. I'll definitely emphasize this timeline at the hearing!
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Luca Ferrari
My cousin works for EDD (not in claims tho) and she says they're systems are super outdated and sometimes claims get flagged for random reasons. She said best thing to do is CALL THEM directly but good luck getting thru lol i spent 3 days trying to reach someone about my claim last year
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Anastasia Popov
•I've been trying to call for days! Keep getting the "we're experiencing high call volumes" message and then it hangs up on me. So frustrating.
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Nia Davis
I had a similar issue last year with EDD mistakenly denying my PFL claim. For your appeal hearing, bring these specific documents: 1. Your original SDI approval letter with dates clearly shown 2. Your SDI final payment notice 3. Your PFL application with timestamp/date 4. Birth certificate 5. Any communications from EDD representatives confirming your eligibility The key issue to address is the proper transition from SDI to PFL. Make sure to explain that you followed the correct procedure by filing for PFL after your SDI pregnancy disability period ended. The judge will want to see that there was no overlap or improper gap. Also, on the DE2508 form (PFL claim form), there's a section that asks if you received SDI benefits. Make sure this was filled out correctly, as an error there could trigger these automatic denials.
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Anastasia Popov
•Thank you for this detailed list! I do have all these documents, and yes, I did correctly note my SDI claim on the DE2508 form. I'll make sure to organize everything for the hearing.
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Mateo Martinez
when i had my baby i got disability first then bonding after so maybe thats the issue? my hr person helped me fill out all the paperwork correctly thank goodness because EDD is so confusing!!!!
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Anastasia Popov
•Yes, I did disability first then bonding! That's why I'm so confused about why they're saying I should have been on disability for those last 3 weeks when I had already used all my disability time.
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QuantumQueen
After dealing with EDD for both my kids' births, I discovered Claimyr (claimyr.com) which actually gets you through to a real EDD representative instead of waiting on hold for hours. Their video demo (https://youtu.be/DOLxZQb92wM?si=6N1iCQ3a8Cdb2Ay5) shows how it works. I was skeptical but it actually connected me with an EDD agent in about 10 minutes when I needed to fix my PFL claim that was delayed. In my experience, getting a knowledgeable representative on the phone who can look at your specific claim details is way more effective than just waiting for the appeal. They might be able to fix the issue right away once they see the timeline of your SDI ending and PFL starting.
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Aisha Rahman
•does this actually work? i've been calling EDD for 2 weeks and can't get through about my maternity claim issue
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QuantumQueen
•Yes, it worked for me! I was able to talk to someone who fixed the issue with my claim transition from pregnancy disability to baby bonding. Much better than waiting for an appeal hearing.
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Aisha Rahman
The same thing happned to me!!! I was almost out of money by the time they fixed it. I think they do this on purpose to avoid paying us. When you have your hearing make sure you print out the EDD website page that clearly shows the difference between SDI and PFL. Also bring a timeline of your pregnancy, delivery, SDI period and when your PFL started. The judge at my hearing was actually nice and overturned the denial after seeing my documentation.
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Anastasia Popov
•That's a great idea to print out the EDD website information. I'll definitely create a timeline too. So glad to hear your judge was reasonable!
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Zara Khan
One more thing to check - make sure there's no confusion about your "effective date" of your PFL claim. The claim date should be the first day after your SDI benefits ended. If there's even a small gap or overlap in the dates, it can trigger these automatic reviews. You mentioned there was a weekend between your SDI ending and PFL starting - this shouldn't be an issue if documented correctly, but sometimes the EDD system gets confused by calendar days versus benefit days. For your appeal, create a day-by-day calendar showing: - Last day of SDI benefits - Weekend days (or other non-claimed days) - First day of PFL benefits This visual timeline helped one of my clients win their appeal in a similar situation.
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Anastasia Popov
•This is so helpful - thank you! My SDI claim ended on a Friday (January 10, 2025) and my PFL claim started on Monday (January 13, 2025). I'll create that day-by-day calendar to make it super clear.
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Luca Ferrari
Just remeber to bring EXTRA copies of EVERYTHING to your hearing cuz they always say they "didnt receive" something even when you sent it like 5 times already!
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Anastasia Popov
•Good point! I'll bring multiple copies of everything.
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