Gap in disability coverage after maternity extended - will EDD backpay? Job protection at risk?
I'm currently on maternity SDI but there's a gap in my coverage and I'm panicking about backpay and job protection. My pregnancy disability was extended by my OB for 2 weeks until January 15th because she submitted a mental health referral. I finally had my psych appointment today (Feb 3rd) due to crazy delays from provider shortages and holiday backlog. The psychiatrist is extending my disability for another 4 weeks from today. My question is: what happens for that gap period between Jan 15th and Feb 3rd? Will EDD refuse to pay me for those weeks since there was no active medical certification? Also, I have Prudential supplemental disability through my employer that pays the other 40% of my salary, but they'll need updated medical forms too. And what about my job protection? Can my employer make me use PTO for those gap weeks or could they technically say I abandoned my position during the uncovered period? Has anyone dealt with coverage gaps during pregnancy disability? I'm so stressed about this!
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Elin Robinson
I had almost the exact same situation last year! Don't panic - you can get this fixed. Your psychiatrist needs to complete a Supplemental Medical Certification (DE2525XX) that specifically covers the gap period. Make sure they clearly document that your condition was continuous, even though there was an administrative gap in getting the appointment. For your job protection, CFRA/FMLA protection should still apply if you've properly notified your employer about the continued medical need. The key is documenting that this was a continuous condition, not that you got better and then worse again.
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Ivanna St. Pierre
•Thank you so much for this info! I didn't know about the supplemental form. Should I ask the psychiatrist to backdate the certification to Jan 16th then? I'm just worried Kaiser will refuse since they're so strict about documentation.
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Atticus Domingo
Call ur HR department ASAP!!! They should be able to tell u exactly what documentation they need. My company made me use PTO for a 5-day gap I had between my regular maternity leave and when my baby was in NICU. It SUCKED and I wish I had asked more questions beforehand. Some companies are super strict about the paperwork timelines.
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Beth Ford
•This isn't entirely correct. California SDI pregnancy disability leave doesn't require you to use PTO for gaps - it's a state benefit, not an employer policy. What matters is getting the medical documentation showing the condition was continuous, even if there was a documentation gap. The employer can't legally force PTO use if it's protected medical leave.
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Morita Montoya
You need to contact EDD directly to sort this out. I tried fixing a similar situation through online messages and it was useless. When I finally got through to an actual human at EDD, they helped me fix my claim in minutes. Trying to get through to EDD's disability department is a nightmare though. I used a service called Claimyr (claimyr.com) to get connected to an agent without waiting on hold for hours. They have a video showing how it works: https://youtu.be/DOLxZQb92wM?si=6N1iCQ3a8Cdb2Ay5. It saved me so much stress during my maternity leave when I had twins and couldn't sit on hold all day.
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Kingston Bellamy
•Does that service really work? I've been trying to call EDD for three days straight about my transition from disability to baby bonding and keep getting disconnected after 45+ minutes on hold.
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Joy Olmedo
back in 2023 i had a 9-day gap in my pregnancy disability because my doctor was on vacation and nobody covered signing my forms lol... EDD eventually paid me for those days but it took like 3 months to get the money. my work tried to say i needed to use PTO but i showed them the temporary disability extension request my doc submitted before leaving and they backed off. document EVERYTHING and save all emails!!!!!
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Ivanna St. Pierre
Update: I called my HR department today and they said I need to submit a continuous leave form from the psychiatrist that specifically states my condition has been ongoing since the original OB certification expired. They're giving me until next Friday to get all the paperwork in before they process it as an unpaid leave gap. At least I know what I need now!
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Elin Robinson
•That's great! Make sure you also submit that documentation to EDD directly for your state disability claim. Your employer's requirements and EDD's requirements can be slightly different. The EDD form you need is called a "Supplemental Medical Certification" and needs to be completed by your doctor. I'd recommend calling EDD to confirm exactly what they need as well.
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Isaiah Cross
The entire system is designed to create these gaps so they don't have to pay you. I had THREE different gaps during my pregnancy disability and baby bonding period. Every time it was because of THEIR delays in processing paperwork that THEY required. And then they act like it's your fault! The whole CA disability system is broken, especially for new mothers. I spent more time fighting with EDD than bonding with my baby during the first month. It's criminal.
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Beth Ford
•While the system definitely has flaws, there are specific procedures for handling gaps in coverage. The important thing is documenting that the medical condition was continuous, even if there were administrative delays in getting appointments or paperwork. EDD will typically backpay if you can show the qualifying condition existed during the gap period.
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Ivanna St. Pierre
Final update: Success! The psychiatrist completed both the EDD supplemental certification and my employer's continuous leave form. He documented that my condition has been ongoing since the original certification expired. HR has confirmed my job protection stays intact with no need to use PTO. Now just waiting on EDD to process the payment for those gap weeks. Thank you everyone for your help!
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Elin Robinson
•So glad to hear this worked out! For anyone else reading this thread in the future, this is why documentation from healthcare providers is so critical during pregnancy disability and PFL claims. Always get paperwork that clearly covers any potential gaps, and don't be afraid to ask your provider to specifically note that a condition was continuous even if there were appointment delays.
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