Although our company focuses on helping people obtain federal Social Security Disability and Supplemental Security Income benefits, a question that we hear often is whether there are also state-sponsored benefits. At present, five states offer disability benefits: California, Hawaii, New Jersey, New York and Rhode Island. Each state is very different in the type of coverage it offers. A brief overview of each state's program is outlined below.
California State Disability
The California State Disability Insurance (SDI) program was established in 1946 to provide some level of wage replacement for workers disabled by a nonwork-related injury or illness, pregnancy or childbirth. The maximum amount that can be received under the program in 2015 is $1,104 per week. The weekly benefit amount is about 55 percent of a worker's earnings up to the maximum. Workers can receive benefits for up to 52 weeks.
The program is funded through payroll deductions. To be eligible for benefits, workers must have been paying into the program for a base period before the claim is filed, usually from five to 12 months prior to filing. Other eligibility requirements include:
- You must be unable to perform your customary work for at least eight consecutive days.You must be either employed or actively looking for work when the claim is filed.
- You must have lost wages because of the disability.
- You must meet the earnings threshold of at least $300 during the five to 12 months before filing the claim.
- You must be under a doctor's care.
- You must file the claim form with 49 days of becoming disabled.
- Your doctor or another licensed care provider must certify that you are disabled.
In some cases, an independent medical examination may be required.
Hawaii Temporary Disability Insurance
Hawaii's Temporary Disability Insurance (TDI) program was established in 1969. To be eligible for benefits, a worker must be currently employed and have at least 14 weeks of employment in Hawaii of at least 20 hours each week. The 14 weeks do not need to be consecutive or with a single employer. Additionally, the worker must have earned at least $400 in each of the weeks. Claims must be filed within 90 days of becoming unable to work or benefits may be reduced or an employee could become ineligible.
Employers in the state pay for TDI and there are several ways this can be accomplished. An employer can purchase an insurance plan that meets minimum state requirements or it can be self-insured and show the state that it has the resources to offer paid leave to disabled employees at or above the statutory minimum benefit requirements.
The minimum benefit that approved employees receive is 58 percent of regular weekly wages. The benefits are available for a minimum of 26 weeks. Self-insured employers and those that have purchased insurance that provides more than the minimum benefit may pay more or provide benefits for a longer time.
As in other states with disability insurance programs, Hawaii employees must have medical documentation of their disabilities to be eligible.
New Jersey Temporary Disability
New Jersey employees who worked in the state for at least 20 weeks during the 52 weeks preceding the onset of a disability and earned $165 or more (for disabilities that began after Jan. 1, 2015) are eligible for benefits. Employees who earned more than $8,300 in the 52 weeks preceding the onset of disability are also eligible. Claims must be filed within 30 days of the onset of disability and benefits can be received for up to 26 weeks.
Workers who are eligible for unemployment benefits may also be eligible under certain circumstances. Benefits are not available under this program for on-the-job injuries.
Benefits are calculated using the average weekly wage based on the eight weeks before the employee became disabled. Workers are paid two-thirds of their average weekly wages, up to a maximum of $604 weekly for disabilities that began after Jan. 1, 2015.
Both employers and employees pay for the program at rates established by the New Jersey Department of Labor and Workforce Development.
New York Disability Benefits
In New York tate, disability benefits can be paid for entirely by the employer or shared between the employer and employee through payroll deductions up to a maximum amount. Employers may purchase an insurance policy that meets the state requirements from an approved carrier or be self-insured. An employer is allowed to share the cost of insurance with employees up to 60 cents per week.
Cash benefits are 50 percent of an employee's weekly wage, but no more than $170 per week. Benefits are available for 26 weeks during a period of 52 consecutive weeks. There is a seven-day waiting period during which no benefits are paid. A claim must be filed within 30 days of becoming disabled.
Eligible employees are currently or recently employed workers who have worked at least four consecutive weeks for a covered employer.
Rhode Island Temporary Disability Insurance
Rhode Island had the first state disability insurance program in the country. Enacted in 1942, the program is funded entirely by workers; the current rate for payroll deductions is 1.2 percent of an employee's first $64.20 in earnings. Eligible employees are those who earned $10,800 during the base period, which is four of the five previous quarters before filing a claim. An applicant must be unable to work for seven consecutive days and be certified by an approved medical provider to be eligible.
The benefit rate is 4.62 percent of the total wages paid in the highest-paid quarter of the base period. The 2015 maximum benefit is $770 and the minimum benefit is $84. Disabled workers with minor or disabled children or other dependents may also be eligible for a dependency allowance.
Although duration of benefits is calculated using the amount received, benefits generally stop after 30 weeks.
General Information About State Disability Programs
This summary does not include the in-depth, detailed information needed to file state disability claims, and there are many other differences between states. In addition to the varying benefit amounts, wait times, length of benefits and eligibility requirements, the states have different requirements for employers. In the five states listed here, the law exempts different types of employers from having to provide disability insurance. The laws in each state also have different ways of defining medical providers. In some, only M.D.s can certify someone as disabled, while in others, nurse practitioners or other types of providers can complete the forms. Some states allow benefit recipients to "double dip," or receive benefits under more than one program, while others do not.
In short, it is important to research the requirements and procedures in each state to determine if you are eligible, if your employer is required to provide insurance, how long you have to file a claim and how long you can expect to receive benefits. Each state has a website that outlines the provisions of its disability program.
Rhode Island: http://www.dlt.ri.gov/tdi/tdifaqs.htm