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Filling a Claim with California

How you get paid while you're away

When life requires time away from work – whether for your own health, welcoming a new child, or to care for a loved one – the process of receiving pay can look a little different. You might be surprised to learn that your time off and pay may be coordinated by not only your employer, but also through other programs designed to support you during important life events. In this case, the California Employment Development Department (EDD).

Now, we realize navigating multiple sources of income can be a daunting task, especially with the EDD, whose processes may feel complex and hard to understand, but we’re here to guide you every step of the way to make that process as simple and as easy as possible.

Let’s take a look at who’s involved and what to expect while navigating this process! (And remember, at any time, you can connect with your personal administrator to help guide you further.)

Who is involved in statutory filing

The Larkin Company

We’re your employer’s third-party administrator (TPA) for leaves of absence; that means we help manage your leave of absence (time away from work) for your employer. You can think of us as the team behind the scenes that ensures your leave is handled as smoothly as possible for you and your employer.

As you already know, your personal Larkin administrator will be guiding you through the entire process from start to finish – from your leave start date to your return-to-work date. Your assigned personal admin will also help process your pay and make sure you’re getting paid accurately and on time – either in full or as a supplement to what the EDD will be paying you while you’re on a leave of absence.

The California Employment Development Department (EDD)

As a California employee, you contribute to a state fund through payroll deductions and this fund is designed to give you partial pay replacement while you’re on a leave of absence, if you qualify. The EDD is the state agency that will determine if you qualify and issue payments to you due to certain types of leave, for example:

  • If you’re unable to work because of a non-work-related illness, injury, or pregnancy, the EDD may provide State Disability Insurance (SDI) benefits.
  • If you’re bonding with a new child, caring for a seriously ill family member, or supporting your military family member, the EDD may offer Paid Family Leave (PFL) benefits.

To qualify and receive benefits, you will need to file a claim separately with the EDD.

The Employee (You)

Your role in this process might make a little more sense now, but here’s a quick recap of the tasks you will need to complete in order to get paid accurately and on time throughout your leave of absence.
1

Reach out to Larkin and request your leave of absence to get started. Your personal administrator will help guide you throughout the entire process from start to finish.

2

File a claim with the EDD . Filing on time prevents delays:

  • (SDI) State Disability Insurance – We recommend filing as soon as you begin your leave, but no later than 49 days after your leave start date. It’s important to note that your benefits will not be payable until the 8th day of your disability since SDI has a 7-day waiting period before benefits begin.
  • (PFL) Paid Family Leave (family care leave, parental/baby bonding) – File your claim on the day your leave begins, but no later than 41 days after your leave start date.
3

Once you start receiving pay from the EDD, you will need to share proof of the pay you’re receiving from the EDD with Larkin, so Larkin can calculate and process the remainder of your pay on behalf of your employer. Send this document to your personal administrator or upload it into your portal account.

4

Expect your pay on a regular cadence and focus on what matters the most- your health, bonding with your new child, or caring for a loved one.

Remember - You can reach out to your personal Larkin administrator with any questions or concerns throughout your leave.
The task You (the Employee) Larkin The EDD
Request a leave of absence
Reach out to your personal Larkin admin to get started
Coordinate with your employer
Submit medical certification completed by your healthcare provider to Larkin
Upload your medical certification to your portal account or email/fax it to your admin
Receive & process your leave
File your claim for SDI or PFL benefits with the EDD
File your EDD claim in the appropriate timeframe to prevent delays in your pay
Receives & processes your claim
Submit medical certification completed by your healthcare provider for your EDD claim
Communicate with your HCP - they may give you the certification to submit to the EDD OR submit the form online themselves
Reviews for benefit approval
Integrate EDD benefits with pay from your employer
Provide us a copy of your pay from the EDD
Review and process the remainder of your pay

What to Expect

The EDD is a BUSY state agency with high call volumes and thousands of applications being processed regularly. And not to mention, the EDD processes can sometimes feel complex and hard to understand.

That’s why this page is here – to help you understand how filing works with the EDD and what you can expect from working with them. Below is a list of common issues employees experience and how you can try to get ahead of them when it’s time for you to file with the EDD.

EDD Common Issues & Keys to Success

  • Due to high call volume, many calls go unanswered, disconnect, or inform you that they are not accepting any more calls for the day.
    • The best time to call the EDD is as soon as it opens (8:00a PST).
  • If the EDD needs more information about your claim, they will call you from an unknown private number. If you miss the call, you may find a voicemail containing the EDD representative informing you that they will call you back in 15 minutes to try getting a hold of you again.

  • When registering for a MyEDD account, the EDD may require an ID.me Verification. This may take up to 30 minutes or more. Some common reasons that the EDD requires ID.me verification include recent changes in name. However, often there is no apparent reason for the EDD to need this info. Nonetheless, you must complete this before you can finish registering.
    • Your information should match what’s on file with the DMV or Social Security Administration. Common accepted documents for verification include:
      • State identification (ID) card
      • Driver license
      • US passport, foreign passport, or passport card
      • US military card (front and back)
      • Military dependent’s ID card (front and back)
      • Permanent Resident Card (Green card)
      • Certificate of Citizenship
      • Certificate of Naturalization (original N-550 or replacement N-570.)
      • US nonimmigrant Visa
      • Border crossing Card (DSP-150)
      • Citizenship card (US or foreign)
      • Consular ID Card
      • Employment Authorization Document
    • You can find the full list of acceptable documents here on the EDD’s website
  • Not completing applications correctly may cause delays.
    • PFL – Question C7: for care for child – you will need to select ‘parental right’ to prevent delays.
    • Dates on application are conflicting, claim may be delayed or denied.
    • If the EDD cannot verify employee’s identity, address, or any other information from their claim, the claim will be delayed.
      • EDD will mail documents to employee directing employee to provide two current, unexpired documents – photo ID & one other identity document, such as a bill, bank account statement, etc.
    • If the employees SSN is entered incorrectly, the EDD will issue a dummy # and the employee will need to obtain a verification letter from the Social Security Administration to confirm their SSN.
    • When applying online, if employee’s employer name is not generating, they will need to check “employer not found” and enter employers name manually.
    • EDD examiner may still delay claims to verify information with you or your employer, even if you’ve entered accurate information.
    • Paper claims not reaching EDD or getting lost, resulting in employees claims not being processed.
      • Contact EDD

  • If you do not have a CA Drivers License or State ID, you will need to file via paper claim.
  • If your name does not match the DMV contact information, the application will result in ‘error’, and you will need to file by paper claim.
  • The EDD does not accept electronic signatures on Part C (statement of family member receiving care) of the PFL application. You must submit a paper claim.
    • Paper claim MUST be filled out in black ink only
    • No PDF or electronic signatures
    • No typed responses
  • If employee’s Health Care Provider does not use SDI Online, you must provide your receipt number to provider to include in your certification to mail to the EDD (you can still file your claim online).
  • If you are unable to file your claim online, please contact your Larkin administrator and they can mail you a paper application.

  • For employees transitioning from State Disability Insurance (SDI) to Paid Family Leave (PFL), you cannot apply for PFL benefits until your SDI claim has been paid out in full.
  • The Notice of Computation is sent to you to let you know what your potential weekly and maximum benefit amount will be based on the wages earned in your base period. This notice does NOT confirm that you are eligible to receive benefits.
  • If your claim is not on an automatic payment, your will receive a Claim for Continued Disability Benefits every two weeks. You will need to sign/date and submit to EDD via MyEDD or mail within 20 days after receipt, or your benefits will stop.

  • Health Care Providers outside the U.S. will not be able to access MyEDD to file online. Health Care Providers must submit a paper copy of the State Disability Insurance/Paid Family Leave claim forms.
  • The EDD will verify overseas Health Care Providers’ medical license. This can take anywhere from 2-4 weeks to a max of 3 months.
  • The EDD may request copies of your plane ticket or itinerary to confirm dates you provided care for your family member.

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