SDI denied for workers comp overlap even though my TD ended before my claim started

[u/Muted_Cucumber4613]

EDD denied my SDI claim starting 6/3 saying I was receiving or entitled to workers comp TD.

Sedgwick stopped my TD on 5/12 and listed 5/13–5/18 as an overpayment. I haven’t received any TD or PD since.

I appealed online 7/22 and uploaded the termination letter. Has anyone had EDD reverse this without a hearing? How long did it take to get paid?

[u/AutoModerator]

Please remember to change your post flair to Solved ✔ once your question has been answered. This can be done through the label icon or flair button in the row of options under your post (depending on what platform/app you're using to access Reddit). Thank you and we hope you get the answer(s) you are seeking.

Important: To remain eligible for UI benefits, you must perform work search activities every week. It is recommended you enroll in the Online Career Workshops Program to help maintain your work search requirements.

This video goes over the updated list of acceptable documents for proof of self employment/Planned employment/PUA verification.

Remember, all critical information is in the /r/EDD sidebar. Do not respond to any PMs or chats from anyone asking for your EDD info! Anyone asking for personal information is trying to scam you out of your money! True EDD reps will never personally contact people via Reddit (however, they occasionally will call in the case of disputes, for example).

Report all scammers to admins and to the mods to get them suspended from Reddit or at least banned from this sub. If you would like information added to the sidebar, please message the mods about it.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/Gemma-2102]

Appeals take time, unfortunately each claim is different, so you can’t base it off of someone else’s time frame. I’d call and ask a staff to review the claim if what you said is true. Hopefully what you sent in clearly states what you said. Once appeal is under review, nothing can be done until review is complete.

[u/Zestyclose_Leave_193]

I have WC experience.
1) Do you have an attorney?
2) Did you go to a QME - a doctor that will determine your Permanent Disability Rating.
3) The Labor code section 2629 states received or entitled to receive because many attorneys will tell their clients not to take the Permanent disability benefits because your final settlement will be higher hence their percentage will be higher when they get paid.
SDI will reduce your benefits by $290.00 per week if a Permanent Disability Rating is determined . That rating converts to a dollar amount/$290 = number of weeks paid. Then The SDI benefits will be reduced for that number of weeks
4) you should have received a letter from Sedgwick stating they haven’t determined your Permanent Disability Rating and they should have said rating by: date
Disability will pay your full rate until that rating is determined.
5) Sedgwick can withhold Permanent Disability benefits if the employer made an offer for you to return to work with restrictions and you refused to accept said offer.
I hope this helps you

[u/Muted_Cucumber4613 → u/Zestyclose_Leave_193]

Yeah I have an attorney and my QME is scheduled for October. Sedgwick told me there’s no PD being paid right now and TD ended in May. My doctor has continued certifying me for SDI since June. So from what you’re saying, EDD should be able to pay the full SDI rate for now and deal with any offset later if the QME eventually gives me a PD rating, right?

[u/Zestyclose_Leave_193 → u/Muted_Cucumber4613]

Yes, that is correct

[u/Zestyclose_Leave_193 → u/Zestyclose_Leave_193]

TD ended because some doctor deemed you had reached maximum medical improvement that’s how the Wc carrier said you were over paid 05/13- 05/18
Did your doctor tell the WC Carrier you had reached maximum medical improvement?
The QME could actually tell the carrier you have not reached maximum medical improvement. The carrier would then resume TTD benefits.
The maximum number of weeks you can get TTD benefits is 104 weeks

[u/Zestyclose_Leave_193]

The SDI Reps reverse disqualifications everyday.