Certify or Extend Claims – Basics for Licensed Health Professionals

Both DI claims and PFL care claims require a medical certification to be complete. Learn more about your role as a licensed health professional. We verify your license, which must be active and in good standing. The following licensed health professionals can certify claims:

• Licensed medical or osteopathic physician/practitioners
• Authorized medical officer of a U.S. Government facility
• Chiropractor
• Podiatrist
• Optometrist
• Dentist
• Psychologist
• Nurse practitioner or physician assistant
• Licensed midwife, nurse-midwife, or nurse practitioner for pregnancy, childbirth, or postpartum conditions. This must be consistent with the scope of their professional licensing.
• Accredited religious practitioner

Important: On January 1, 2024, Senate Bill 667 changed the scope of nurse midwife certification authorization.

You and your patients can file and certify for DI and PFL benefits online or using a paper form. The DI and PFL paper claim forms are:

• Claim for Disability Insurance (DI) Benefits (DE 2501)
• Claim for Paid Family Leave Benefits (PFL) Benefits (DE 2501F)

DI and PFL claim forms can be ordered and sent to you at no cost by visiting Online Forms and Publications. For more information or access to forms and publications, you can:

• Visit Licensed Health Professional Forms and Publications.
• Call 1-855-342-3645 (TTY users dial the California Relay Service at 711).

Claim applications must be complete, signed, and include all attachments. When reviewing your certification forms, we pay special attention to:

• Diagnoses.
• International Classification of Diseases (ICD) codes.
• Estimated recovery dates.
• Timeframe needed to provide family care.
• Patient’s age, gender, and occupation.
• Patient’s medical history.

Who needs to sign and certify?

• On DI claims you and your patient must both sign and certify the claim information.
• On PFL care claims you, your patient, and their caregiver must all sign and certify the claim.

 If you provide a longer recovery date than expected on a diagnosis we may:

• Contact you and/or your patient for more information.
• Send the patient to an Independent Medical Examiner for a second medical opinion.

A detailed explanation of the long recovery time may help avoid the need to ask you for more details.

To file a medical certification online, you must:

• Have a license through the California Department of Consumer Affairs.
• Complete a one-time registration in myEDD.

Note: For out-of-state providers, call 1-855-342-3645 before you complete your registration.

After you have completed the registration process through myEDD, follow these steps:

1. Log in to your myEDDaccount.
2. Select SDI Online
3. Select Register as a Physician/Practitioner
4. Complete the ID.me verification.
5. Follow the rest of the registration process as directed.

Registration is available from Monday to Saturday 4 a.m. to 12 midnight and Sunday 4 a.m. to 9 p.m.

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

1. Log in to your myEDD
2. Select SDI Online which will direct you to your Home page.
3. Search for your patient's information using one of the following:
   • The Receipt Number issued when they filed a claim using SDI Online.
   • The claim ID number.
   • Claimant/patient's last name and date of birth.
   • Claimant/patient's last name and Social Security number.
4. Locate your patient's claim under Search Results. Select the Submit Physician/Practitioner certificate link under the Action column.
5. On View Claimant DE 2501 or DE 2501F, review patient information and select Next to continue.
6. Complete your certification by answering the questions, and providing the information requested including ICD Codes.

Note: It is important that your certification is accurate, signed, and returned to us as soon as possible. You must return the form within 49 days from the date the DI claim begins and 41 days from the date the PFL claim begins.

For Disability Insurance claims:

• Fill out and sign Part B – Physician/Practitioner’s Certificate on the Claim for Disability Insurance (DI) Benefits (DE 2501).
• Mail it to us within 49 days from the date your patient’s disability begins.

For Paid Family Leave claims:

• Fill out and sign Part D – Physician/Practitioner’s Certification on the Claim for Paid Family Leave (PFL) Benefits (DE 2501F) form.
• Mail it to us within 41 days from the date family leave begins.

You can mail the forms to us using the pre-addressed envelope provided. Do not mail these forms to us if you already submitted the claim online. Sending duplicate certifications can create processing problems and delays for your patient’s claim. Failure to return them on time may cause a denial of your patient’s benefits.

Complete the forms using these tips:

• 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.)

 You may need to provide a medical extension for your patient's disability or need for care if:

• It extends beyond the original recovery date on their initial claim.
• It extends beyond the most recent medical extension filed.

Submit one of these forms:

Disability

• Physician/Practitioner’s Supplementary Certificate (DE 2525XX)

If you have an SDI Online account, access this form by logging in to your myEDD account and selecting SDI Online.

From your Home page

• Select Claim ID or last four digits of SSN from the Search By drop down menu.
• Enter the Claim ID or last four of the SSN for the patient.
• Enter the patient’s last name and date of birth (no dashes).
• Select Search to continue.
• Under Search Results find your patient’s claim ID. Under the Action column, select the link Submit Additional Medical Information.
• On the next screen, select the 2525XX under My Forms Available to Submit. Complete the required information.

You can also get a paper copy from your patient. Return this form to us online or by mail to the address on the form within 20 days of the mailing or online delivery date.

Paid Family Leave

• Paid Family Leave (PFL) Supplemental Claim Certification (DE 2525XFA)

If your patient’s caregiver needs to continue providing care, complete the "Physician/Practitioner’s Supplementary Certificate" section of this form. The form must return to us at the address on the form within 20 days of the mailing date.