Filing Your Disability Claim

Disability insurance provides short term benefits to workers who suffer a loss of wages when they are unable to work due to a non-work related illness or injury, or a medically disabling condition related to pregnancy. Most workers in California are covered by State Disability Insurance (SDI). The Patient Records office at Kaiser Permanente Santa Clara can assist members with filing a disability claim.

Where to file:

You may submit disability claim forms at the Kaiser Permanente facility where you receive your care. At the Kaiser Permanente Santa Clara Medical Center you may submit forms Monday through Friday between the hours of 9:00 a.m. and 5:00 p.m. at the location below:

Kaiser Permanente Santa Clara Medical Offices
Homestead Campus
Dept 160 Patient Records
710 Lawrence Expressway
Santa Clara, CA 95051-5173

Patient Records (408) 851-1750
Disability Claims (408) 851-1744

What to file:

You may bring your employer-supplied disability claim form with you or you may pick up a State of California "Claim for SDI Benefits" form in Patient Records at the above address during regular office hours. You should complete the patient portion of the claim form prior to submission.

If your physician has provided a "Verification of Treatment" (VOT) form to you with an estimated return to work date, submit this with your disability claim form. This will expedite the filing process.

At the time you submit your claim, you may be asked to complete a Kaiser Permanente "Authorization for Use and / or Disclosure of Member / Patient Health Information" form authorizing Kaiser Permanente to release your medical information.

When to file:

State disability forms should be filed just prior to or within 49 days of the start of your disability. Private disability claim forms such as Matrix, Unum, VPA, etc. may be submitted earlier when a known period of disability is anticipated.

Payment:

Disability claim forms are normally processed and forwarded to the State Disability Insurance (SDI) office within 5 to 10 business days following their receipt in the Kaiser Permanente Patient Record’s office.

Claims submitted with a Verification of Treatment (VOT) form with an estimated return to work date documented by your physician can usually be processed more quickly.

The SDI office typically issues your first disability check within about two weeks of receiving your claim.

Extensions:

If you will not be able to return to work on the date originally estimated by your physician, you will need to obtain another Verification of Visit (VOT) form from your physician with a new estimated return to work date documented.

Submit the new VOT form with your extended return to work date to Patient Records in Department 160.

Extensions should be filed prior to the expiration of the original return to work date to avoid disruption of benefits.

SDI Contact Information and Resources:

Questions about disability eligibility and benefit amounts should be directed to a State Disability Insurance (SDI) office. The address of the San Jose SDI office is:

State Disability Insurance
P.O. Box 637
297 West Hedding
San Jose, CA 95106-0637

Information about the status of your disability claim can be obtained by calling 1-800-480-3287. State of California employees should call 1-866-352-7675.

Information about SDI is available at http://www.edd.ca.gov/fleclaimdi.htm

General information about disability benefits is available at http://www.disabilitybenefits101.org/.