Epilepsy Benefits in California: 2025 Guide

• To qualify for federal disability benefits (SSI/SSDI), you must have a medically determinable impairment that prevents substantial gainful activity for at least 12 months or is expected to result in death. Epilepsy is listed as a qualifying condition if it meets specific criteria, such as frequent seizures despite medication or significant limitations in daily activities.
• SSI is for low-income individuals with limited resources, while SSDI is for those with a qualifying work history. Both programs require medical evidence, such as doctor’s reports and seizure logs.
• Children with epilepsy may qualify for SSI if they meet childhood disability criteria and their family’s income is below the limit.
• You must report changes in income, living situation, or medical status to avoid overpayments.

Learn more about SSI vs SSDI

• California State Disability Insurance (SDI) provides short-term income replacement for those unable to work due to non-work-related illness, injury, or pregnancy. For epilepsy, this means you must be unable to work for at least eight consecutive days due to seizures or related complications.
• Paid Family Leave (PFL) allows you to take time off to care for a seriously ill family member, including a child with epilepsy.
• In 2025, SDI/PFL benefits increase to 70-90% of wages, with a maximum weekly benefit of $1,681. The payroll contribution rate is 1.2% of earnings, with no wage cap.
• You must have earned at least $300 in the past 12 months from which SDI deductions were withheld to qualify for SDI.
• Claims can be filed up to 30 days in advance of the anticipated first day of leave, and the Employment Development Department (EDD) must issue payment within 14 days of claim receipt or the start date, whichever is later.
• California Medicaid (Medi-Cal) covers epilepsy-related medical care, including medications, doctor visits, and hospital stays, for those with low income and resources.

Learn more about Medicaid Waivers (HCBS)

• Gather medical records and seizure logs.
• Determine eligibility for SDI, PFL, SSI, SSDI, or Medi-Cal.
• File SDI/PFL claims online at myEDD up to 30 days before leave.
• Apply for SSI/SSDI online at SSA.gov or by phone.
• Apply for Medi-Cal through Covered California or your county social services agency.

• Step 1: Collect all necessary medical documentation, including doctor’s reports, seizure logs, and medication lists.
• Step 2: Review eligibility requirements for each program (SDI, PFL, SSI, SSDI, Medi-Cal).
• Step 3: File an SDI or PFL claim online at myEDD. You can file up to 30 days before your anticipated first day of leave. The EDD will process your claim and issue payment within 14 days of receipt or the start date, whichever is later.
• Step 4: Apply for SSI or SSDI online at SSA.gov, by phone at 1-800-772-1213, or in person at a local Social Security office. Provide all required medical and financial information.
• Step 5: Apply for Medi-Cal through Covered California or your county social services agency. You may need to provide proof of income, residency, and disability.
• Step 6: Keep records of all applications, correspondence, and payments. Report any changes in income, living situation, or medical status to avoid overpayments.
• Step 7: If denied, you have the right to appeal. Follow the instructions provided by the agency.

Learn more about Avoiding Overpayments & Reporting Changes

• Social Security Disability Insurance (SSDI): Provides monthly payments to people with epilepsy who have a qualifying work history. Payments are based on your earnings record.
• Supplemental Security Income (SSI): Provides monthly payments to low-income individuals with epilepsy, regardless of work history. Payments are based on financial need.
• Medicare: Available to people with epilepsy who receive SSDI after a 24-month waiting period. Covers hospital, medical, and some prescription drug costs.
• Medicaid: Available to people with epilepsy who meet income and resource limits. Covers a wide range of medical services, including epilepsy-related care.

Learn more about Medicaid vs Medicare

• California State Disability Insurance (SDI): Provides short-term income replacement for those unable to work due to non-work-related illness, injury, or pregnancy. In 2025, benefits increase to 70-90% of wages, with a maximum weekly benefit of $1,681. The payroll contribution rate is 1.2% of earnings, with no wage cap.
• Paid Family Leave (PFL): Allows you to take time off to care for a seriously ill family member, including a child with epilepsy. Benefits are the same as SDI.
• California Medicaid (Medi-Cal): Covers epilepsy-related medical care, including medications, doctor visits, and hospital stays, for those with low income and resources.
• In-Home Supportive Services (IHSS): Provides in-home care for people with epilepsy who need assistance with daily activities.
• California ABLE Accounts: Tax-advantaged savings accounts for people with disabilities, including epilepsy, to save for qualified expenses without losing eligibility for means-tested benefits.

Learn more about California ABLE Accounts

• California ABLE Accounts allow people with epilepsy to save up to $18,000 per year (2025 limit) in a tax-advantaged account for qualified disability expenses, such as medical care, education, housing, and transportation.
• ABLE account balances do not count toward SSI or Medi-Cal resource limits, up to $100,000.
• To open an ABLE account, you must have a qualifying disability that began before age 26 and meet other eligibility requirements.

Learn more about ABLE Accounts

• SSI: In 2025, the federal SSI payment is $943 per month for an individual and $1,415 for a couple. California adds a state supplement. Income and resource limits apply.
• Medi-Cal: Income limits vary by program. For most adults, the limit is 138% of the federal poverty level. For children, it is higher.
• SDI/PFL: No income limit, but benefits are based on your earnings. The maximum weekly benefit in 2025 is $1,681.
• ABLE Accounts: Contribution limit is $18,000 per year (2025). Account balance limit for SSI is $100,000.

• You must report changes in income, living situation, or medical status to avoid overpayments.
• If you receive an overpayment, you may be required to repay it. You can request a waiver if the overpayment was not your fault.
• Keep records of all payments and correspondence.
• Report changes promptly to the agency that provides your benefits.

Learn more about Avoiding Overpayments & Reporting Changes

• California Employment Development Department (EDD)
  Phone: 1-800-480-3287

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  For SDI and PFL claims and questions
• Social Security Administration
  Phone: 1-800-772-1213

  TTY: 1-800-325-0778

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  For SSI and SSDI applications and questions
• California Department of Health Care Services
  Phone: 1-800-541-5555

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  For Medi-Cal questions

• What is California State Disability Insurance (SDI)?

  SDI provides short-term income replacement for California workers unable to work due to non-work-related illness, injury, or pregnancy. For epilepsy, this means you must be unable to work for at least eight consecutive days due to seizures or related complications.

• How much will I get from SDI in 2025?

  In 2025, SDI benefits increase to 70-90% of your wages, with a maximum weekly benefit of $1,681. The exact amount depends on your earnings and the length of your leave.

• Can I file an SDI claim in advance?

  Yes, you can file an SDI claim up to 30 days before your anticipated first day of leave. The EDD will process your claim and issue payment within 14 days of receipt or the start date, whichever is later.

• What is Paid Family Leave (PFL) in California?

  PFL allows you to take time off to care for a seriously ill family member, including a child with epilepsy. Benefits are the same as SDI, up to 70-90% of wages, with a maximum weekly benefit of $1,681 in 2025.

• How do I apply for SSI/SSDI with epilepsy?

  You can apply for SSI/SSDI online at SSA.gov, by phone at 1-800-772-1213, or in person at a local Social Security office. You will need to provide medical evidence, such as doctor’s reports and seizure logs.

• What medical evidence do I need for disability benefits?

  You need medical records, doctor’s reports, seizure logs, and medication lists. The evidence must show that your epilepsy prevents you from working or causes significant limitations in daily activities.