DMV/Disability Forms

DMV Reporting

California Law(California Health and Safety Code Section 103900: Safety Code 103900) requires physicians to report patients with conditions which result in lapses of consciousness, episodes of confusion or dementia. Please be advised that your neurologist does not have to authority to grant you driving privileges, nor to hasten the review process: only DMV has that authority. After you have been reported, the DMV will send paperwork to you that must be completed by your physician. Please allow at least one week for your physician to complete this paperwork. If you would like a copy please indicate that on the forms. Please remember to sign the release on the back page.

All inquiries regarding driver's license status, reinstatement of driving privileges, hearings, appeals, etc, should be directed to:

Department of Motor Vehicles
180 Martinvale Lane, San Jose, 95119
(800) 777-0133

Lapses of Consciousness

Additional information can be obtained at the DMV website: Lapses of Consciousness Disorders

Disability Forms

STATE DISABILITY INSURANCE (SDI)

To initiate a claim for State Disability benefits, obtain a State Disability Claim form (available from the Business Office at each healthcare facility), complete your portion of the form, and return it to the Business Office. The Business Office will have the Doctor’s Certificate portion completed by your physician, and then forward it to the State.

Disability checks are issued every two weeks, commencing approximately ten working days from date claim is received. Benefits begin on the 8th day following the date you first became disabled. In the event of hospitalization or outpatient surgery, benefits will commence on the first day hospitalized or the date of the outpatient surgery. You are entitled to draw state disability benefits for 12 months from date first disabled.

For further information, please contact:

Silicon Valley WIB-San Jose One-Stop
1775 Story Road
San Jose, CA 95122
408-928-1300
Hours: M-F 9a - 5p

SOCIAL SECURITY DISABILITY

You are eligible to apply for Social Security disability as soon as you become disabled. Your local Social Security Office can advise you on the application process (this can be lengthy and we recommend you initiate your claim as soon as possible), as well as the amount of your monthly benefit.

For further information:

The Social Security Website offers extensive information regarding the entire Social Security disability process.

You may use their toll-free number: (800) 772-1213 or TTY (800)352-0778

Or apply in person at:

Social Security Office
6140 Cottle Road
San Jose , Ca 95123
Hours: Monday - Friday:09:00 am - 04:30 pm

STATE DEPARTMENT OF REHABILITATION

The State Department of Rehabilitation offers retraining for patients who are permanently disabled from their usual occupation, but who wish to receive training for employment in a new field. Patients will continue to receive State Disability Insurance (SDI) benefits while participating in a retraining program.

Further information regarding retraining programs can be obtained from your local State Rehabilitation Office:

Piedmont Hills Branch
1333 Piedmont Road, Suite 106
San Jose, CA 95132-2478
(408) 277-9011

You may wish to contact your employer or Human Resources Department to inquire about possible disability benefits to which you may be entitled. If you are covered by a collective bargaining agreement, you may also wish to contact your local union representative regarding possible benefits through your union.

Disclaimer
If you think you have a MEDICAL OR PSYCHIATRIC EMERGENCY, CALL 911 IMMEDIATELY or go to the nearest hospital. DO NOT attempt to access emergency care through this web site. An emergency medical condition is a medical or psychiatric condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in any of the following: serious jeopardy to your health, serious impairment to your bodily functions, or serious dysfunction of any bodily organ or part. An emergency medical condition is also "active labor," which means a labor when there is inadequate time for safe transfer to a Plan hospital (or designated hospital) before delivery or if a transfer poses a threat to the health of the member or unborn child.

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