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Employment Development Department
Employment Development Department

How to File a Paid Family Leave Claim by Mail

To file a Paid Family Leave (PFL) claim by mail, complete and submit a Claim for Paid Family Leave (PFL) Benefits (DE 2501F). Follow the steps below to properly submit a PFL claim by mail.

1. Obtain a Paper Claim Form

You can obtain a paper Claim for Paid Family Leave (PFL) Benefits (DE 2501F) form a few different ways:

New mothers transitioning from a Disability Insurance (DI)-related pregnancy claim to bonding: When you have recovered from delivering your baby, a Claim for Paid Family Leave (PFL) Benefits – New Mother (DE 2501FP) will be automatically mailed to you in a separate envelope at the same time your final DI payment is issued.

2. Gather Required Information

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

Provide the information below ONLY if it applies to you:

3. Complete Claim for Benefits

New mothers transitioning from a DI-related pregnancy claim to bonding: Complete all sections of the DE 2501FP and submit no later than 41 days from the date you wish to begin your bonding claim. No additional documentation is required.

All other claimants filing for bonding or care claims: Complete Part A, Claimant’s Statement (page 1), of the DE 2501F form. Be sure to write clearly in the spaces provided, use black ink only, and sign the form.

After your paper claim has been received, your physician/practitioner may search for your claim in SDI Online using the last four digits of your Social Security number, last name, and date of birth.

It is your responsibility to have the physician/practitioner complete and sign the form and submit it to the EDD within 49 days from the date your family leave begins or you may lose benefits.

For more information, review the Guide for Completing a Claim Form for Paid Family Leave Benefits.

For line by line instructions visit our Paid Family Leave – Manual Forms page.

4. Mail the Completed Claim for Paid Family Leave (PFL) Benefits (DE 2501F)

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

Important: