Transcription

State Disability InsuranceDisability Insurance and Paid Family LeaveClaimant Presentation

AgendaToday’s webinar will cover topics including: California’s State Disability Insurance Program Disability Insurance Information Paid Family Leave Information Eligibility Information State Disability Insurance vs Job Protections The Claim Filing Process

What Is State Disability Insurance?Disability InsurancePaid Family Leave

Responding to COVID-19Disability Insurance and Paid Family Leave benefitshave been made available for Californians coveredby State Disability Insurance who are affected bythe novel coronavirus (COVID-19). Disability Insurance: Available to eligible workers if you’reunable to work due to having or being exposed to COVID-19(certified by a medical professional). Paid Family Leave: Available to eligible workers whotake time off from work to care for an ill or quarantinedfamily member with COVID-19 (certified by a medicalprofessional).For additional information, visit: edd.ca.gov/about edd/coronavirus-2019.htm edd.ca.gov/about edd/coronavirus-2019/faqs.htm

Which U.S. Locations HaveState Disability Insurance?CaliforniaConnecticutHawaiiNew JerseyNew YorkOregonPuerto RicoRhode IslandMassachusettsWashingtonWashington DC

State Disability Insurance Funding1.0%withholding rate 122,909taxable wage limit 1,229.09maximum yearly claimant contribution

About Disability InsuranceDisability Insurance providespartially paid leave for a nonwork-related illness, injury, orpregnancy. Provides up to 52 weeks ofbenefits if medically certifiedby a physician/practitioner. You may work part timeand receive partial or fullDisability Insurancebenefits. You receive 60 to 70percent of your salary.

Five Things ToKnow AboutPaid Family Leave123Up to six*weeks ofbenefits in a12-monthperiod.Bond with anew child orcare for anill familymember.Can be splitup over a12-monthperiod.45No waitingperiod.This is not agovernmentassistanceprogram.*Benefits increase to eight weeks for claims that start on or after July 1, 2020.

Two Paid Family Leave Claim Types:Care and BondingShare your Paid Family Leave story on Instagram @CA PFL

Paid Family Leave:CareCalifornia’s Paid Family Leave payseligible workers up to six weeks ofbenefits to be there for the momentsthat matter most. Caring for a seriously ill or injuredfamily member. Caring for an out-of-state or outof-country family member. Requires a physician/practitionerto certify to illness and need forcare.

Paid FamilyLeave: BondingPaid Family Leave pays eligiblemothers and fathers up to sixweeks of benefits to bond with anew child within the child's firstyear. Used to bond with a biological,adopted, or foster child. Requires documentationshowing proof of relationship.

Disability Insurance,Paid Family Leave,and New/ExpectingMothersNew mothers can take Disability Insurance leave followed by PaidFamily Leave, for example:DisabilityInsurance4 WeeksBirthDisabilityInsurancePaid FamilyLeave6 - 8 Weeks6 weeks**You can split up the six weeks of Paid Family Leave. You do nothave to take it all at once.

Calculating the Benefit Amount Your weekly benefit amount is determined by yourhighest quarter of earnings in your base period. Your base period consists of taxable wagesearned 5-18 months prior to your claim start date. To simplify this process, estimate your weeklybenefit amount using the EDD calculator atedd.ca.gov/Disability/PFL Calculator.htm

Determining the Base Periodthe

Determining the Base PeriodBase PeriodQuarters 15,657 12,249 11,180 12,249ClaimEffectiveDate 11,180June 1(QTR 1)Jan-Mar(QTR 2)Apr-Jun(QTR 3)Jul-Sep(QTR 4)Oct-Dec(QTR 5)Jan-Mar(QTR 6)Apr-Jun

How Is the Wage Replacement Rate Determined?If your highest quarterly earnings are: Less than 929, the weekly benefitamount is 50. Between 929 and 5,741.67, theweekly benefit amount is approximately70 percent of your earnings. 5,741.68 or more, the weekly benefitamount is approximately 60 percent ofyour earnings.

Doing the Math 15,657 13 1204.38 1204.38 x 60% (0.60) 722.63 722.63 is rounded up to 723

Determining EligibilityHave you paid into California’s StateDisability Insurance (noted as CASDIon a paystub) in the 5-18 monthsprior to taking leave?If you answered “yes,” you are mostlikely eligible for benefits. Review paystubs beforeassuming eligibility. Citizenship and immigrationstatus do not affect eligibility.

Employment Status and StateDisability InsuranceUnemployedindividuals must belooking for work and/orcollectingUnemploymentInsurance.Seasonal employees,part-time workers, andunemployedindividualsmay still qualify.A self-employedindividual may beeligible if contributingto the DisabilityInsurance ElectiveCoverage program.

Can a Claimant Work Part Time andQualify for Benefits?Yes, if: You work less than yourregular and customaryhours. You lose wages. The reduction of work hoursis due to your disability orfamily leave claim.

What is Integration?Integration issupplementing SDIbenefits with youravailable leave credits.Must not exceed 100%of your regular pay.

Job ProtectionsDoes the StateDisabilityInsuranceprogram providejob protection?No, the StateDisability Insuranceprogram does notprovide jobprotection, justpaid benefits.However, otherstate andfederal lawsmay apply whileyou are usingyour leave.

Job ProtectionsLaws that may apply while receivingDisability Insurance and Paid FamilyLeave benefit payments: Family and Medical Leave Act(FMLA) California Family Rights Act (CFRA) New Parent Leave Act (NPLA) Fair Employment and Housing Act(FEHA) Pregnancy Disability Leave (PDL)Visit the Department of Fair Employment andHousing at dfeh.ca.gov or the Department ofLabor at dol.gov/whd/fmla to learn more.

The Claim FilingProcess

Filing a DisabilityInsurance ClaimComplete and submit yourclaim within 49 days from thedate your disability begins by:Online: Filing through SDIOnline is strongly recommendedbecause it can expedite thereview process.Mail

OnlineDisability Insuranceand SDI OnlineThe EDD recommends filingyour Disability Insuranceclaim using SDI Online. Register and log on toBenefit Programs Online. Select “New Claim” in yourSDI Online account tobegin your application.Create or access your accountby visiting edd.ca.gov/BPO

MailFiling a DisabilityInsurance ClaimA properly completed DisabilityInsurance claim will include: Part A – Claimant’s Statement(pages 1-4) Part B – Physician/Practitioner’sCertificate (pages 5-7)Order the Claim for DisabilityInsurance (DI) Benefits (DE 2501)online at edd.ca.gov/forms

Filing a Paid FamilyLeave ClaimEach program requires its ownclaim to be filed.You must complete and submit yourclaim within 41 days from the dateyour family leave begins.There are two ways to file:OnlineMail

OnlinePaid Family Leaveand SDI OnlineSDI Online is your fast,convenient, and secure way tosubmit your Paid Family Leaveclaim online.Create or access your account byvisiting edd.ca.gov/BPO

MailFiling a PFL CareClaimA properly completed care claimwill include: Part A – Statement of Claimant Page 2 – Care Recipient’sAuthorization Part C – Statement of CareRecipient Part D – Physician/Practitioner’sCertificationOrder the Claim for Paid FamilyLeave (PFL) Benefits (DE 2501F)online at edd.ca.gov/forms

MailFiling a PaidFamily LeaveBonding ClaimA properly completed bondingclaim will include: Part A – Statement of Claimant Part B – Bonding Certification Supporting documentationverifying the relationshipOrder the DE 2501F applicationonline at edd.ca.gov/forms

OnlineNew/ExpectingMothersIf you are transitioning from aDisability Insurance pregnancyclaim to a Paid Family Leavebonding claim and you filed yourDisability Insurance claim usingSDI Online, you will receive a linkin your inbox to apply for benefitselectronically.

MailNew/ExpectingMothersIf you filed your claim by mail,you will receive a Claim for PaidFamily Leave (PFL) Benefits –New Mother (DE 2501FP) bymail after the final DisabilityInsurance payment.

What Happens Next?Once a properly completed claim isreceived: Allow at least 14 days forprocessing. The EDD mails a Notice ofComputation (DE 429D) after aproperly completed claim isreceived. Electronic Benefit PaymentNotification (DE 2500E) is sentafter claim is approved. An EDD Debit CardSM or check issent after first benefit paymentissued.

Benefit Payment Options EDD Debit CardSMElectronic BenefitPayment You can download the Bank ofAmerica App to access youraccount information. Check

Extending the Disability Period Benefits are paid through your expectedreturn to work date provided by thephysician/practitioner. The Physician/Practitioner’sSupplementary Certificate (DE 2525XX) ismailed after your final benefit payment isissued. To extend benefit payments, thephysician/practitioner must complete andsubmit the DE 2525XX.

Certifying forContinued Benefits Claim for ContinuedDisability Benefits(DE 2500A) Notice of AutomaticPayment(DE 2587) Disability ClaimContinuing EligibilityCertification(DE 2593)

Re-Establishing or Continuinga Paid Family Leave Claim Bonding Claims: Request To ReEstablish A Bonding Claim forPaid Family Leave (DE 2504RE). Care Claims: Paid Family Leave(PFL) Supplemental ClaimCertification (DE 2525XFA).For either claim type, you mayalso file a new DE 2501F.

Disability Insurance and Paid Family LeaveDisability InsurancePaid Family LeavePersonal illness, injury, pregnancy, ordisability.Need to care for a seriously ill familymember or to bond with a new child.Wage loss and unable to performregular or customary work.Wage loss due to the need for care orbonding.Up to 52 weeks per claim.Up to six weeks every 12-month period.Must be under the care of aphysician/practitioner.The care recipient must be under thecare of a physician/practitioner.Not required to use vacation benefits.Your employer may require you to useup to two weeks of vacation.Vacation pay does not conflict with DI.Vacation pay conflicts with PFL whenyou are is required to use it for yourleave.Benefits are not reportable to IRS(unless in lieu of UI).Benefits are reportable to IRS.

For more information on DisabilityInsurance or Paid Family Leave,visit: edd.ca.gov/disability californiapaidfamilyleave.comContact EDD DI English: 1-800-480-3287 DI Español: 1-866-658-8846 PFL English: 1-877-238-4373 PFL Español: 1-877-379-3819

Your Paid FamilyLeave Story edd.ca.gov/disabilityCalifornia Paid Family Leaveallows you to be there for themoments that matter. californiapaidfamilyleave.comShare your [email protected] PFL on dFamilyLeave

Any Questions?The EDD is an equal opportunity employer/program. Auxiliaryaids and services are available upon request to individuals withdisabilities. Requests for services, aids, and/or alternateformats need to be made by calling 1-866-490-8879 (voice).TTY users, please call the California Relay Service at 711.

Online Disability Insurance and SDI Online The EDD recommends filing your Disability Insurance claim using SDI Online. Register and log on to Benefit Programs Online. Select “New Claim” in your SDI Online account to begin your application.