Nonindustrial Disability and Family Care Claim Process

NDI (Disability claims)

Excluded employees and rank-and-file employees in BU 2, 5, 6, 7, 8, 9, 12, 13, 16, 18, and 19 with or without an Annual Leave Program (ALP) are eligible for NDI. It provides benefits to eligible employees when they lose wages due to a non-work-related disability:

• Illness or injury (physical or mental)
• Surgery (including elective surgery)
• Pregnancy
• Childbirth or other related medical conditions
• Alcohol or drug addiction recovery.

To be eligible for NDI benefits, you must be:

• An active state employee not covered by SDI.
• Unable to do your regular work for at least eight days due to a non-work-related disability.
• Losing wages due to your disability.
• Under the care of a physician/practitioner or accredited religious practitioner. Care must start within the first eight days and continue through your disability. This affects your claim start date.

NDI-FCL (Family leave for Bonding, Care, and Military Assist claims)

Only employees of BU 2, 7, 9, 12, 16 with ALP and excluded employees with ALP are eligible for NDI-FCL.

NDI-FCL provides benefits for employees who need time off for family leave to:

• Bond with a new child.
• Care for a seriously ill family member.
• Support a family member in the US armed forces who is deploying to a foreign country.

To be eligible for NDI-FCL benefits, you must be:

• An active, excluded state employee or in a specific bargaining unit, not covered by SDI. Exempt employees who don’t earn leave are not eligible.
• Enrolled in the Annual Leave Program.
• A full-time employee, part-time employee, or an intermittent employee. (See note)
• Unable to do your normal work due to a need for family leave.
• Having a wage loss due to your need for family leave.

Note: Part-time employees must have six months of service within the last 18 months. Intermittent employees must have 960 hours of employment.

• Your disability or family leave begins the first day you cannot work due to your disability or need for family leave.
• You can file your claim after your disability or family leave begins.
• Questions about your claim start date? Contact us at 1-866-758-9768 before filing your claim.
• Your NDI claim may have a 7 or 10-day waiting period. For details, check your Memorandum of Understanding (MOU) or ask your personnel specialist.
• NDI-FCL claims do NOT have a waiting period.

NDI is not automated. You must fill out paper forms to start your claim.

Ask your personnel specialist or payroll officer for the:

• First Claim for Nonindustrial Disability Insurance (NDI) (DE 8501) (PDF)

NDI claim form DE 8501 completion steps:

• Part A - Employer Information:
  • Employer confirms your job status and verifies if you are on ALP/Enhanced NDI.
  • Employer completes and signs Part A.
• Part B - Claim Statement of Employee:
  • You complete and sign Part B.
• Part C - Physician/practitioner Certificate:
  • Attach your completed, signed medical certification.
  • Mail the complete, signed form to the address on Instruction page A.

NDI – FCL is not automated. You must fill out paper forms to start your claim.

Ask your personnel specialist or payroll officer for the:

• Claim for Nonindustrial Disability Insurance - Family Care Leave (NDI-FCL) (DE 8501F) (PDF)

NDI-FCL claim form DE 8501F completion steps:

• Part A - Employer Information:
  • Employer checks your job status.
  • Employer confirms you’re enrolled in the Annual Leave Program and excluded from bargaining units or part of a specific bargaining unit.
  • Employer completes and signs Part A.

• Bonding Claims - Part B and C:
• You complete and sign Part B – Claim Statement of Employee.
• You complete and sign Part C – Bonding Certification and attached required bonding documents.

• Care Claims - Part B, D, and E:
  • You complete and sign Part B – Claim Statement of Employee.
  • Part D Statement of Care Recipient - completed and signed by care recipient or representative.
  • Part E Physician/practitioner’s Certification for Care claims.

• Military Assist Claims - Part B, F, and Qualifying Event:
  • You complete and sign Part B – Claim Statement of Employee.
  • You complete and sign Part F and complete the Qualifying Event for Military Assist claims and attach required supporting documents.

Mail the complete, signed application, with supporting documents to the address on Instruction page A.

NDI claims require a medical certification for your disability claim to approve benefits.

Have your physician/practitioner fill out and submit Part C - Physician/Practitioner Certificate of the claim form. You are responsible for making sure the form is complete, signed and sent to us.

Note: Your claim is not completed until we receive the signed medical certification form with your application. We send incomplete claims back to you. If we don’t get both parts together, you may delay your claim.

Mail the entire completed NDI application to:

Employment Development Department
NDI
PO Box 2168
Stockton, CA 95201-2168

NDI-FCL care claims require a medical certification to approve care benefits for your family member.

Have your family member fill out and sign Part D Statement of Care Recipient. Their Physician/practitioner must fill out and sign Part E - Physician/Practitioner Certificate of the DE 8501F claim form. You are responsible for making sure the form is complete, signed, and sent to us.

Note: Your claim is not complete until we receive the signed certification form together with your application. We send incomplete claims back to you. If we don’t get both parts together, you may delay your claim.

Mail the entire completed NDI-FCL application to:

State of California Employment Development Department
NDI-FCL
PO Box 2168
Stockton, CA 95201-2168

Once we get your complete claim application, we’ll check your eligibility within 14 days. Processing may take longer if the claim is incomplete or needs more information.

Before receiving NDI benefits, you must serve a 7 or 10-day unpaid waiting period. The period depends on your job and bargaining unit. The waiting period is calendar days. Some situations may allow us to waive all or part of the waiting period. Check your bargaining agreement for conditions and guidelines.

NDI-FCL does not have a waiting period.

Once processed, we’ll send you:

• The Notice of Eligibility for Nonindustrial Disability Insurance or Nonindustrial Disability Insurance - Family Care Leave (NDI-FCL) (DE 8500) form. It will show your approved period of benefits available.

We’ll send your employer:

• The Authorization to Pay Nonindustrial Disability Insurance or Nonindustrial Disability Insurance - Family Care Leave (NDI-FCL)(DE 8500A) form. It will show your approved period of benefits available.

If you are not eligible, we will send you a Notice of Determination (DE 8517) and an Appeal Form (DE 1000A). You can appeal within 30 days using the DE 1000A form.

For more information, visit State Disability Insurance Appeals.

After your initial claim approval, you can get benefits until your physician/practitioner’s estimated recovery date. Once we confirm your claim, we’ll mail you a Physician’s Supplementary Certificate (DE 8500B) form.

If you have not recovered, have not exhausted your claim benefits, and need to continue benefits, you must submit a medical extension DE 8500B form. Your physician/practitioner must complete and sign this form. Either you or your physician/practitioner can mail this form back to us to review.

This form is not available to view or order online. If you need a medical extension form, call 1-866-758-9768.

If you recover or return to work on the date your physician/practitioner gave us, you do not need to take any action. Your claim will stop.

If you return to work before the recovery date, complete and return the DE 8500 form. If you get sick or injured again, file a new claim form (DE8501) and report the dates you worked.