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Employment Development Department
Employment Development Department

How to File a Disability Insurance (DI) Claim by Mail

To file a DI claim by mail, complete and submit a Claim for Disability Insurance (DI) Benefits (DE 2501). Follow the steps below to properly submit a DI claim by mail.

1. Obtain a Paper Claim Form

You can obtain a paper Claim for Disability Insurance (DI) Benefits (DE 2501) form by:

2. Gather Required Information

You must provide the following information to file a DI claim:

Provide the information below ONLY if it applies to you:

3. Complete Part A: Claimant’s Statement

Complete Part A - Claimant’s Statement (pages 1-4), of the DE 2501 form. Be sure to write clearly in the spaces provided, use black ink only, and make sure you sign the form.

Note: Do not complete any portion of Part B – Physician/Practitioner’s Certificate of the DE 2501 form.

Important:

4. Physician/Practitioner Completes Part B: Medical Certification

After completing Part A, contact your physician/practitioner about completing, signing, and submitting your medical certification (Part B – Physician/Practitioner’s Certificate, pages 5-7). You are responsible for obtaining a Physician/Practitioner Certification for your disability. Be sure to talk to your physician/practitioner about their process for submitting a DI claim; they do not all follow the same process. Some offices may have you mail in Part B, while others may mail in Part B themselves.

Your physician/practitioner may complete and submit the medical certification on the paper form or through SDI Online. The certification must be submitted no later than 49 days after your disability begins or you may lose benefits.

Important:

5. Mail in the Completed Claim for Disability Insurance (DI) Benefits (DE 2501)

To submit the claim, mail the completed paper claim form to the EDD in the pre-addressed envelope to:

State of California
Employment Development Department
P.O. Box 989777
West Sacramento, CA 95798-9777

Important:

For more information, visit Claimant Tutorial and After You File for DI: Claim Processing.

If you are not eligible for benefits: A Notice of Determination (DE 2517) will be mailed to you. You must meet eligibility requirements in order to receive benefits. To learn more about eligibility requirements, visit Am I Eligible for DI?  If you are disqualified from receiving benefits, you will receive an Appeal Form (DE 1000A) with your disqualification notice. You have the right to appeal any decision, in writing, within 20 days of the mailing date of the disqualification notice. For more information, visit Appeals.