アメリカ開業医の独り言

 天ちゃん先生のリクエストでこの記事を書いています。月給性の人は、毎月給料から保険料が天引きされます。自営業の人は、３ヶ月おきにその保険料を、州に支払います。その保険料は給料の０.8％です。そして医師の病気で仕事が出来なくなったという証明があれば、２週間以上の場合、今まで払った額で給料の半分ぐらい、定期的に本人に小切手が毎週送られます。それは、過去に支払った保険料から、月給が、裁定されます。以下に加州でのEDDの英語の説明をコピーしました。　　EDDサイトは以下です。下のブルーをクリックすれば、年収に応じた、毎週の小切手の額がわかります。つまり年収２００，０００ドルで毎週８４７ドルもらえます。１ドル１００円で計算すると、年収２０００万円のひとは、毎週８万４千７百円もらえます。これは年額で４４０万円です。これと、会社勤務の人は、会社のほうで、プライベイトで入っていて、両方で、半額の１０００万円です。勤務医の場合もそれに近いものがもらえます。開業医は、自分でプライベイトに入り、それは、その保険会社で支給額は、異なります。以前ある５０歳の会社員が脳梗塞で倒れて、仕事に行けなくなり、会社がずっと、健康保険とプライベイトのDISABILITYの保険を支払ってくれて、一生年収の５０％から６０％はもらっていました。AMA（アメリカ医師会）などが、開業医のためのプライベイトのDISABILITYの保険があり、病気で働けなくなったら、代診の医師や、従業員の給料そして、クリニックの賃貸料が払えるぐらいの保険金がもらえるものもあります。

http://www.edd.ca.gov/Disability/About_the_Program.htm 

 

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 Eligibility

Eligibility for Disability Insurance (DI)

DI benefits can be paid only after you meet all of the following requirements:

• You must be unable to do your regular or customary work for at least eight consecutive days.
• You must be employed or actively looking for work at the time you become disabled.
• You must have lost wages because of your disability or, if unemployed, have been actively looking for work.
• You must have earned at least $300 from which SDI deductions were withheld during a previous period.
• You must be under the care and treatment of a licensed doctor or accredited religious practitioner during the first eight days of your disability. (The beginning date of a claim can be adjusted to meet this requirement.) You must remain under care and treatment to continue receiving benefits.
• You must complete and mail a claim form within 49 days of the date you became disabled or you may lose benefits.
• Your doctor must complete the medical certification of your disability. A licensed midwife, nurse-midwife, or nurse practitioner may complete the medical certification for disabilities related to normal pregnancy or childbirth. (If you are under the care of a religious practitioner, request a “Practitioner's Certificate,” DE 2502, from the SDI office. Certification by a religious practitioner is acceptable only if the practitioner has been accredited by Employment Development Department.)

An independent medical examination to determine your initial or continuing eligibility may be required.

Ineligibility - Disability Insurance (DI)

You may apply for benefits even if you are not sure you are eligible. If you are found to be ineligible for all or part of a period claimed, you will be notified of the ineligible period and the reason. You may not be eligible for SDI benefits if:

• You are not suffering a loss of wages
• You are claiming or receiving Unemployment Insurance or Paid Family Leave benefits.
• You became disabled while committing a crime resulting in a felony conviction.
• You are in jail, prison, recovery home, or any other place because you were convicted of a crime
• You are receiving Workers' Compensation benefits at a weekly rate equal to or greater than the DI rate.
• You fail to have an independent medical examination when requested to do so.
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• Benefit Amounts

• Your claim begins on the date your disability began. SDI calculates your weekly benefit amount using your base period. The date your disability began determines your base period, unless the claim effective date is adjusted by SDI.

  If you want your claim to begin later so that you will have a different base period, please call SDI at 1-800-480-3287 before you file your claim.

  This base period covers 12 months and is divided into four consecutive calendar quarters. Your base period includes wages subject to SDI tax which you were paid approximately 5 to 17 months before your disability claim begins. Your base period does not include wages being paid at the time the disability begins. The quarter of your base period in which you were paid the highest wages determines your weekly benefit amount. Refer to the DI Weekly Benefit Chart for further information.

  (You may need to download the free Adobe Reader to view and print linked documents.)

  You may not change the beginning date of your claim or adjust your base period after you have established a valid claim.

  Your daily benefit amount is your weekly benefit amount divided by seven. Your maximum benefit amount is 52 times your weekly benefit amount or the total wages subject to SDI tax paid in your base period, whichever is less. Exceptions are as follows:

• For employers and self-employed individuals who elect SDI coverage, the maximum benefit amount is 39 times the weekly rate or the total wage credits in the base period, whichever is less. The minimum weekly benefit amount is $51 for DIEC participants.
• For residents in a state-approved alcoholic recovery home or drug-free residential facility, the maximum payable period is 90 days. (However, disabilities related to or caused by acute or chronic alcoholism or drug abuse which are being medically treated do not have this limitation.)＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿