State Disability Insurance
For a patient who has lost wages as a result of an illness that prevents them from continuing to work, they may qualify for State Disability Insurance. It is recommended that patients apply for state disability benefits even if they are unsure whether they qualify. State Disability Insurance provides benefits for up to 12 months.
State Disability Insurance applications can be found at the Clinical Social Work office or by requesting one from the clinical social worker assigned to your care. Please call the Clinical Social Work office at 626-256-4673, ext. 62282, for more assistance.
Caregivers may qualify for Paid Family Leave Benefits, which are provided by California's Employment Development Department (EDD) to extend disability compensation to cover individuals who take time off to care for a seriously ill child, spouse, parent or registered domestic partner, or to bond with a new minor child.
Paid Family Leave provides monetary benefits but will not provide job protection or return-to-work rights. It provides approximately 55 percent of lost wages, with caregivers eligible for up to six weeks of benefits in a 12-month period.
Paid Family Leave applications can be found at the Clinical Social Work office or by requesting one from the patient’s clinical social worker. Please call the Clinical Social Work office at 626-256-4673, ext. 62282, for more assistance.
It is important to note that State Disability Insurance and Paid Family Leave Benefit applications should be mailed no earlier than nine days — but no later than 49 days — after the first day the patient became disabled or the first day that the family care leave began.
For further inquiries regarding specific situations, visit the EDD website at www.edd.ca.gov, or call State Disability Insurance representatives at 800-480-3287. TYY access is available at 800-563-2441.
*Adapted from the EDD website; Form DE 8714C Rev. 23 (4-02) (Internet): From EDD Form DE 2511 Rev. 4 (1-08) (Internet).
Caregivers may also benefit from FMLA, which offers employees up to 12 weeks of excused unpaid absence from their jobs each year. Employees qualify for FMLA leave when either they or a family member suffer from a “serious health condition.” Such conditions must either prevent the worker from performing his or her job or require the worker to care for a family member. Employees must have worked at their company for more than 12 months and worked at least 1,250 hours during the previous year to be eligible. Smaller employers may not be required to offer FMLA leave to their employees.
FMLA requires that companies return employees to their former positions, assuming they are able to perform their essential job function. If an employee is no longer able to perform the previous job, an alternative position with the same benefits, salary and hours must be provided to the disabled employee.
There are three kinds of FMLA leave:
Continuous FMLA Leave: The employee is absent for more than three consecutive business days and has been treated by a doctor.
Intermittent FMLA Leave: An employee is taking time off in separate blocks due to a serious health condition that qualifies for FMLA. Intermittent leave can be in hourly, daily or weekly increments.
Reduced Schedule FMLA Leave: An employee needs to reduce the amount of hours worked per day or per week, often to care for a family member or to reduce stress.
Each employee is responsible for requesting the necessary paperwork from the employer. This paperwork includes the FMLA Medical Certification Form and the FMLA Notification Form.
*Adapted from the FMLA Web site: fmlaonline.com
Social Security Disability Insurance
The patient may be eligible for Social Security Disability Insurance (SSDI) benefits, which are available for people who have been disabled for 12 months or longer. This is considered a “long-term disability” plan. Generally, Social Security Disability benefits will continue as long as a medical condition has not improved and the patient cannot work.
Social Security Disability benefits usually take an average of five to six months to be processed. It would be helpful for caregivers to encourage the patient to apply for SSDI after receiving State Disability Benefits for six months or being disabled for six months.
Applying early in this way ensures that by the time the patient reaches 12 months of disability, he or she will be able to begin receiving benefits instead of risking lapse of time in benefits. If benefits are denied due to applying too soon, wait a month or so and call back requesting to reprocess the application.
If you think the patient may be eligible for payments, contact the Social Security Administration at (800) 772-1213 to file a claim or ask questions regarding eligibility. A family member may file a claim on behalf of the individual requesting benefits.
Supplemental Security Income
If the patient does not qualify for SSDI, he or she may qualify for Supplemental Security Income (SSI), which is a federal program under Social Security that provides monthly cash payments to people who are 65 or older, as well as blind or disabled people of any age, including children. If not a U.S. citizen but a legal resident, he or she may still be able to qualify for SSI benefits.
For the patient to qualify for this program, he or she must have little or no income and few resources available. This means that the value of all belongings must be less than $2,000 if single or less than $3,000 if married. The value of the patient’s home is not counted.
If eligible for SSI benefits, the patient usually can get medical assistance (Medi-Cal) automatically without making a separate application to Medi-Cal. For questions about Medi-Cal specifically, contact your local county welfare office.
When contacting the Social Security Administration office to begin the application process, patients will be screened to determine qualification for SSDI or SSI.
*Adapted from Social Security Administration SSA Publication No. 05- 11125 January 2009; Social Security Administration – SSA Publication No. 05-10057 August 2001. ICN 463240.
The AHCD is a document that allows an individual to appoint someone else as a decision maker in case the person is unable to make decisions for himself or herself. It provides direction about future medical decisions. It helps to ensure that an individual’s wishes are carried out and respected. It also helps open up conversations about wants and needs related to medical treatment with appointed family members while providing opportunities for loved ones to be involved in the decision-making process.
Considering certain options at early stages of treatment ensures that an individual’s quality of life and values will be honored. It also keeps family members or friends from having to guess what a person’s wishes are, or having to make critical medical decisions under very stressful or emotional circumstances.
City of Hope has AHCD forms available to patients. Forms can be found at the Clinical Social Work office and the Sheri & Les Biller Patient and Family Resource Center. Please call 626-256-4673, ext. 62282 or ext. 32273, for further assistance.