Apply for Disability Insurance Elective Coverage

Be sure you are familiar with the Disability Insurance Elective Coverage (DIEC) program and eligibility requirements in our Information Sheet: Elective Coverage for Employers and Self-Employed Individuals (DE 231EC) (PDF) before you fill out the application.

You can apply for the DIEC program by completing the application and mailing it to the address on the form.

• Application for Disability Insurance Elective Coverage (DE 1378DI) (PDF)
• Application for Unemployment Insurance, Disability Insurance, and Paid Family Leave Elective Coverage Under Section 708(A) of the Unemployment Insurance Code (DE 1378A) (PDF)

Filing a Claim

If you are covered by DIEC and need more information, you can view your options to file for:

• Disability Insurance (DI)
• Paid Family Leave (PFL)

Contact DIEC

To speak with a representative, call:

• DIEC Unit at 1-916-654-6288.
• EDD Taxpayer Assistance Center at 1-888-745-3886.
• TTY users dial the California Relay Service at 711.

Representatives are available Monday through Friday from 8 a.m. until 5 p.m. Offices are closed weekends and holidays.