How to File a Disability Insurance Claim by Mail
To file a Disability Insurance (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:
- Visiting Online Forms and Publications and ordering a form online to have it mailed to you.
- Obtaining the form from your physician/practitioner or employer.
- Visiting an SDI Office.
- Calling 1-800-480-3287.
2. Gather Required Information
You must provide the following information to file a DI claim:
- First and last name.
- Social Security number.
- California Driver License number.
- Most current employer’s business name, phone number, and mailing address (as stated on your W-2 or paystub).
- Last date you worked your regular duties and hours or date you began working at less than full duty or modified duty.
Provide the information below ONLY if it applies to you:
- Any wages you received or expect to receive from your employer (sick leave, paid-time-off (PTO), vacation pay, annual leave, and wages earned after you stopped working).
- Any workers’ compensation claim information, if applicable.
- If you receive in-patient treatment at an alcoholic recovery home or drug-free facility, provide the name, address, and phone number of the home or facility.
3. Complete Part A: Claimant’s Statement
Complete Part A - Claimant’s Statement (pages 1-4), of the DE 2501 form. Write clearly in the spaces provided, use black ink only, and sign the form.
Note: Do not complete any portion of Part B – Physician/Practitioner’s Certificate of the DE 2501 form.
- When to submit a claim: Submit your claim no earlier than nine days after the first day your disability begins, but no later than 49 days after your disability begins, or you may lose benefits.
- Duplicate claims: Do not submit duplicates of the same claim. This will delay claim processing.
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. 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.
- If your physician/practitioner wishes to submit Part B – Physician/Practitioner’s Certificate using SDI Online, allow 14 calendar days for the EDD to receive and process your claim.
- After your claim has been received, your physician/practitioner may search for your claim in SDI Online using the last four digits for your Social Security number, last name, and date of birth or claim I.D. and last name.
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
- Put a stamp on the envelope.
- Mail your claim no earlier than nine days after the first day your disability begins, but no later than 49 days after your disability begins, or you may lose benefits.
- For faster processing, use SDI Online to file your claim.
- Do not submit duplicates of the same claim. This will delay claim processing.
- A properly completed application will include Part A - Claimant’s Statement, and Part B - Physician/Practitioner’s Certificate of your DE 2501. Your claim will not be processed until all the required parts of the application are received.
- Note that your employer will be notified that you have submitted a DI claim. However, your detailed information is confidential and will not be shared with your employer.
If you are not eligible for benefits: A Notice of Determination (DE 2517) will be mailed to you. You must meet eligibility requirements 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 30 days of the mailing date of the disqualification notice. For more information, visit Appeals.