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Employment Development Department
Employment Development Department

Eligibility

Basic Eligibility for Your Employees

Eligibility for Disability Insurance (DI)

DI benefits can be paid only after your employees meet all of the following requirements:

An independent medical examination to determine the individual’s initial or continuing eligibility may be required.

Ineligibility - DI

Your employee may apply for benefits even if they are not sure they are eligible. If they are found to be ineligible for all or part of a period claimed, they will be notified of the ineligible period and the reason. Your employee may not be eligible for DI benefits if they:

Eligibility for PFL

Employees covered by SDI are also covered for PFL. If a Voluntary Plan insurer provides your company’s disability insurance coverage, then it must also provide PFL coverage.

An employee may submit a claim for PFL insurance benefits for the following reasons:

A serious health condition means an illness, injury, impairment, or physical or mental condition of a patient that involves inpatient care in a hospital, hospice, or residential medical care facility. This includes any period of incapacity (e.g., inability to work, attend school, or perform other regular daily activities) or any subsequent treatment in connection with such inpatient care; or continuing treatment by a physician/practitioner unless complications arise. Cosmetic treatments, the common cold, influenza, earaches, upset stomach, minor ulcers, and headaches other than migraine are examples of conditions that do not meet the definition of a serious health condition for purposes of PFL benefits.

Ineligibility - PFL

Your employee may not be eligible for PFL benefits if they: