Social Security Disability Benefits in California

The Social Security Administration (SSA) has a strict disability standard, with five different areas they look at, as determined by their bluebook.

The California Department of Social Services website states that to qualify for SSDI, the disability must be a physical and/or mental condition that:

• Has lasted, or is expected to last, for a minimum of 12 months, or death is expected to result from the disability
• Prevents the person from being able to perform any substantial work, also referred to as substantial gainful activity (SGA).

“Substantial work” in 2021 means earnings of $1,310 per month (up from $1,260 in 2020). Any income below this cap still allows you to be eligible for SSDI.

You must have worked for a long enough time, recently enough, and paid taxes on your earnings to be insured. By working and paying Social Security taxes, you can earn work credits. The amount of earnings required to earn a credit changes each year. In 2020, earning $1,410 was needed to earn one work credit. To qualify for SSDI, the number of work credits required varies by age, and so the number of years you are required to have worked also varies.

You must be under the age of 65 to qualify for SSDI. If you do qualify for SSDI, you will automatically qualify for Medicare after receiving SSDI benefits for 2 years.

SSDI benefits are unique to each person and based on your average lifetime earnings, with a maximum benefit amount that is adjusted each year. In 2020, the cap was $3,011; for 2021, the cap is $3,148. If you are eligible for SSDI, your benefits will not take into account the severity of your disability or how much income you currently have.

Most SSDI recipients receive between $800 and $1,800 per month—the average for 2021 is $1,277.

You can apply for SSDI in three different ways:

1. Apply online
2. Apply over the phone
3. Apply in person at your local Social Security office. You can find your local office here, or see below for all California hearing offices.

The application will go to the Disability Determination Service Division (DDSD), a state agency under the California Department of Social Services. There, a disability claims examiner will make the medical determination as to whether you qualify for disability benefits.

The process for applying for SSDI or appealing a decision is cumbersome. Contact a Social Security Disability advocate or representative today.

Approval rates are not high across the nation, and California’s approval rate is about the same as the national average. If you are denied benefits, you can request that DDSD reconsider your claim. If DDSD denies you again, you can then request an appeal hearing in front of an administrative law judge.

As of October 2020, the California average for winning a disability hearing is 46%.

SSDI applications generally take 3-5 months to process, without accounting for further delays experienced if your SSDI application is rejected for any reason and you decide to go through the multi-step appeals process.

The average wait time for an SSDI appeal hearing is 14.5 months. See statistics for individual hearing offices in California here.

In 2020, California’s SSDI approval rate is about the same as the national average:

The SDI program is an insurance plan for eligible California workers that is funded through employee payroll deductions. An SSDI beneficiary in California may also qualify for the SDI, which provides up to 12 months of help to people with disabilities who used to work. The SDI benefit is 60-70% of your normal wages. The SDI program covers more than 18 million California workers.

People can receive SDI benefits in tandem with SSDI benefits with no reduction in SSDI benefits. The only exception to this is if the combination SSDI and any other disability benefit exceed 80% of what SSA considers your average current earnings based on their formulas.

To file an SDI claim in California, your employer or health care practitioner will generally provide the form. It is also available on the website of the state’s Economic Development Department (EDD). Your health care practitioner must complete part of it, and the form must be submitted to the EDD within 48 days of becoming disabled.

Employers in California must provide workers’ compensation benefits to employees by paying for workers’ compensation insurance. The insurance company will pay for an employee’s medical treatment required, any lost wages incurred, and potentially compensation for permanent impairment or job retraining if a worker suffers from an injury that is work-related or becomes sick from job conditions.

SSDI and SSI are both programs under the Social Security Administration and are often confused with one another. They do have a lot in common but have very different requirements.

While the SSDI is based on disability and work credit, the SSI was specifically created for low-income people who are disabled but do not qualify for SSDI benefits. SSI recipients in California can also receive benefits from the California State Supplemental Program (SPP). All but eight states offer state supplements that augment the monthly federal SSI payment.

California’s DDSD has 11 branches across the state.

Under the Office of Hearings Operations (OHO), administrative law judges (ALJ) conduct hearings and issue decisions.