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Certificación y administración de solicitudes - Información básica para profesionales de la salud con licencia

Conozca la información básica para la certificación y administración de las solicitudes del Seguro de Incapacidad (DI, por sus siglas en inglés) y del Permiso Familiar Pagado (PFL, por sus siglas en inglés) como profesional de la salud con licencia.

Conozca más acerca de su función y sobre quién puede certificar las solicitudes del paciente.

Antes de su certificación

Tanto usted como el paciente deben certificar que la información proporcionada en las solicitudes del DI o PFL está completa y exacta. En general, las solicitudes debidamente completadas se procesan en un plazo de dos semanas desde su recepción.

Cuando revisamos los formularios de certificación, prestamos especial atención a:

  • Los diagnósticos
  • Los códigos de la Clasificación Internacional de Enfermedades (ICD, por sus siglas en inglés)
  • Las fechas estimadas de recuperación
  • El periodo de tiempo necesario para proporcionar cuidado familiar
  • La edad, el género y la ocupación del paciente
  • El historial médico del paciente

Si la fecha estimada de recuperación se extiende más de lo que se esperaría para ese diagnóstico, es posible que nos comuniquemos con usted y/o su paciente para solicitar información adicional. También es posible que enviemos al paciente con un examinador médico independiente para obtener una segunda opinión médica. Proporcionar suficiente información y una explicación de la extensión del periodo de tiempo puede reducir nuestra necesidad de realizar esta solicitud.

Cómo realizar la certificación

Para las solicitudes del Seguro de Incapacidad, complete y firme la sección Part B – Physician/Practitioner’s Certificate de la Solicitud de Beneficios del Seguro de Incapacidad (DI) (DE 2501/S). Envíe este documento por correo postal en un plazo de 49 días a partir de la fecha en la que comienza la incapacidad del paciente.

Para las solicitudes del Permiso Familiar Pagado, complete y firme la sección Part D – Physician/Practitioner’s Certification de la Solicitud de Beneficios del Permiso Familiar Pagado (PFL) (DE 2501F/S). Envíe este documento por correo postal en un plazo de 41 días a partir de la fecha en la que comienza la ausencia familiar.

A continuación encontrará información sobre cómo presentar una certificación. Para más información le ofrecemos un tutorial paso por paso (solamente en inglés).

You must be licensed through the California Department of Consumer Affairs to file a medical certification online. You will need to complete a one-time registration in myEDD.

myEDD is a secure portal that connects you to disability, paid family leave, unemployment and benefit overpayment services.

With myEDD, you can register for an access account, register for SDI Online, and login to SDI Online to view your patient’s initial claim for benefits, fill out and submit claim certifications, and view claim certification history.

Note: You will be directed to complete the ID.me process before you create a new SDI Online account or before you can continue the certification of claims on your existing SDI Online account.

After you have completed the registration process through myEDD and SDI Online, file your certification by following these steps:

  1. Log in to your myEDD account.
  2. Select SDI Online which will direct you to your Home page.
  3. Search for your patient's information using one of the following:
    1. The Receipt Number issued when they filed a claim using SDI Online.
    2. The claim ID number.
    3. Claimant/patient's last name and date of birth.
    4. Claimant/patient's last name and Social Security number.
  4. After locating your patient's claim, complete your certification by answering the applicable questions, and providing the information requested.

You can mail the forms to the EDD using the pre-addressed envelope provided. Do not mail these forms to the EDD if you have already submitted the claim online. Failure to return them on time may cause your patient’s benefits to be denied

To avoid delays in claims processing, complete Part B of Claim for Disability Insurance (DI) Benefits (DE 2501) or Part D of Claim for Paid Family Leave (PFL) Benefits (DE 2501F) forms as follows:

  • Use black ink only.
  • Type or write clearly within the boxes provided.
  • Do not fax the form.
  • Mail the completed form to the EDD in the pre-addressed envelope provided.
  • Include the licensed health professional’s original signature.
  • Include the licensed health professional’s license number.
  • Include the estimated date the patient will be able to return to his/her regular or customary work or the estimated date your patient will no longer require care.  
  • Include the diagnosis and ICD9 code, (If a diagnosis has not been established, a detailed statement of disabling symptoms must be provided.)

Changes to Your Patient’s Claim

If your patient’s disability or the need for care extends beyond the original period of time that was on their initial claim or the most recent medical extension, they will ask you to complete and submit an additional medical certification:

  • Physician/Practitioner’s Supplementary Certificate (DE 2525XX) – You can access this form by logging in to your myEDD account and selecting SDI Online. You can also get a paper copy from your patient.
  • Paid Family Leave (PFL) Supplemental Claim Certification (DE 2525XFA) – If your patient’s caregiver needs to continue providing care, you must complete the "Physician/Practitioner’s Supplementary Certificate" section of this form.

Religious Practitioners

If you are an accredited religious practitioner, you can download and print the following forms. Do not compete these forms if you are a licensed health professional.

Drug and Alcohol Recovery

You may certify your patients for a limited period in an alcoholic recovery home or drug-free residential facility. The facility must be licensed and certified by the state in which the facility is located.

Workers’ Compensation

If your patient has an industrial-related illness or injury, please have the patient contact their employer regarding Workers’ Compensation benefits.

Using SDI Online: In Section 4A – Claim Information, mark "Yes" or "No" to the question, "Was this disabling condition caused and/or aggravated by the patient’s regular or customary work?"

Using the paper claim form DE 2501: On Part B – Question B29, mark "Yes" or "No" to the question, "Was this disabling condition caused and/or aggravated by the patient’s regular or customary work?"

Claim Forms

DI and PFL claim forms are available at no cost to you. For more information on how to access these forms, you can:

Disability Insurance and Paid Family Leave Benefits

Find DI Information for You

Register for myEDD

Creating an account is an important step in this process. With myEDD, you can apply for Disability Insurance and manage your claim in SDI Online.

Create Account Log In

Additional Resources

Can’t find what you are looking for? View these DI and PFL resources for more information.