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California • Rare/Genetic
People with Prader-Willi Syndrome in California may qualify for federal and state disability benefits, including SSI, SSDI, Medicaid, and ABLE accounts. California also offers State Disability Insurance (SDI) and Paid Family Leave (PFL) with increased benefits in 2025.
People with Prader-Willi Syndrome may qualify for federal disability benefits if their condition meets Social Security’s definition of disability. For adults, this means the condition must prevent substantial gainful activity and last at least 12 months. Children may qualify for SSI if their condition severely limits daily activities. SSDI is for adults with a work history. SSI is for those with limited income and resources. Both programs require medical documentation and regular reporting of changes in income or health status. ^1
In California, people with Prader-Willi Syndrome may qualify for State Disability Insurance (SDI) and Paid Family Leave (PFL). SDI provides short-term wage replacement for non-work-related illness or injury, including conditions like Prader-Willi Syndrome. PFL allows time off to care for a seriously ill family member or bond with a new child. Starting in 2025, SDI and PFL benefits increase to 70% or 90% of wages, with a maximum weekly benefit of $1,681. The payroll contribution rate increases to 1.2% of earnings, with no wage cap. Claims can be filed up to 30 days in advance, and payments must begin within 14 days of claim receipt or the start of leave, whichever is later. ^2
Start with Social Security for SSI/SSDI and EDD for SDI/PFL. [^1][^2][^3]
California ABLE accounts allow people with disabilities to save money for disability-related expenses without affecting SSI or Medicaid eligibility. Up to $17,000 can be contributed per year, and the account can grow tax-free. Funds can be used for education, housing, transportation, employment training, and other disability-related expenses. ^5
SSI and Medicaid have strict income and resource limits. For SSI, the 2025 federal benefit rate is $943 per month for an individual. Medicaid income limits vary by program and household size. ABLE accounts do not count toward SSI or Medicaid resource limits, but withdrawals for non-qualified expenses may affect eligibility. ^1
It is important to report changes in income, resources, or health status to avoid overpayments. Overpayments can result in repayment demands and loss of benefits. Report changes to Social Security for SSI/SSDI and to EDD for SDI/PFL. ^1
Starting in 2025, California SDI and PFL benefits increase to 70% or 90% of wages, with a maximum weekly benefit of $1,681. Claims can be filed up to 30 days in advance, and payments must begin within 14 days of claim receipt or the start of leave.
People with Prader-Willi Syndrome in California may qualify for SSI, SSDI, Medicaid, and Medicare. SSI is for those with limited income and resources. SSDI is for those with a work history. Medicaid provides health coverage. Medicare is for those who receive SSDI for 24 months.
California offers State Disability Insurance (SDI), Paid Family Leave (PFL), Medicaid waivers, In-Home Supportive Services (IHSS), and ABLE accounts. SDI and PFL provide wage replacement for disability and family caregiving. Medicaid waivers and IHSS provide home and community-based services.
Apply for SSI/SSDI online at ssa.gov or by phone at 1-800-772-1213. You will need medical records, proof of income, and identification. Submit required forms and documentation, and follow up on claim status.
Apply for SDI/PFL online at edd.ca.gov or by phone at 1-800-480-3287. You will need medical certification and wage information. Submit required forms and documentation, and follow up on claim status.
SSI has a federal benefit rate of $943 per month for an individual in 2025. Medicaid income limits vary by program and household size. ABLE accounts do not count toward SSI or Medicaid resource limits.
Disclaimer: This guide is for informational purposes only and does not constitute legal or financial advice. Always consult with a qualified professional for personalized guidance.
An ABLE account is a tax-advantaged savings account for people with disabilities. Up to $17,000 can be contributed per year, and funds can be used for disability-related expenses without affecting SSI or Medicaid eligibility.
Starting in 2025, SDI and PFL benefits in California increase to 70% or 90% of wages, with a maximum weekly benefit of $1,681. Claims can be filed up to 30 days in advance, and payments must begin within 14 days of claim receipt or the start of leave.
Report changes in income, resources, or health status to Social Security for SSI/SSDI and to EDD for SDI/PFL. Overpayments can result in repayment demands and loss of benefits.
Medicaid waivers provide home and community-based services for people with disabilities. Apply through your county social services agency. Waivers help pay for services not covered by regular Medicaid.
IHSS provides in-home care for people with disabilities who need help with daily activities. Apply through your county IHSS office. Services are based on need and eligibility.
