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Acceptable Documents for Verification

If we can’t verify your identity, address, or any other information from your filed claim, we will notify you by mailing one of these two forms:

  • Request for Eligibility Information Disability Insurance (DE 4365DI) for your disability claim
  • Request for Eligibility Information Paid Family Leave (DE 4366PFL) for your family leave claim

How to Verify Your Identity or Other Claim information

The DE 4365DI or DE 4366PFL will tell you what additional documents you must send to us to verify your identity. The form will also give you the date to respond, usually 10 calendar days from the mailing date. You should respond as soon as possible to avoid delays on your claim or a denial of benefits.

Your information will be kept confidential. Citizenship and immigration status do not affect eligibility.

To request more time to reply, you must call disability at 1-800-480-3287 or PFL at 1-877-238-4373. You may also mail a request to the “Return to” address shown at the top of the DE 4365DI or DE 4366PFL request form we mailed to you.

Identity Verification

For us to verify your identity, you must provide two current, unexpired documents:

  • One Photo Identification (see list below.)
  • At least one Other Identity Document (see list below.)

For additional information view the Department of Motor Vehicles Residency-Documents List and Federal Non-Compliant DL/ID Card-Documents List.

Photo Identification Examples

Your photo identification must show your name, date of birth, and photograph.

You can use any document from this list. For cards, include the front and back.

  • State identification (ID) card
  • Driver license
  • US passport, foreign passport, or passport card
  • US military card (front and back)
  • Military dependent’s ID card (front and back)
  • Permanent Resident Card (Green card)
  • Certificate of Citizenship
  • Certificate of Naturalization (original N-550 or replacement N-570.)
  • US nonimmigrant Visa
  • Border crossing Card (DSP-150)
  • Citizenship card (US or foreign)
  • Consular ID Card
  • Employment Authorization Document

Other Identity Documents

You can use any document from the following list.

  • Utility bill (electricity, gas, garbage, or sewer dated within the last two months.)
  • Cable TV bill (dated within the last two months.)
  • Phone bill (dated within the last two months.)
  • Medical bill (dated within the last two months.)
  • Insurance statement (dated within the last two months.)
  • Bank account statement (dated within the last two months.)
  • Mortgage statement (dated within the last two months.)
  • Property tax bill from the current tax year.
  • Lease or rental agreement showing your name and residence address with current rental or lease dates.
  • Verification that the individual is registered or is an authorized user of a PO Box or Private Mailbox.
  • Government-issued federal, state, county, or city documents that include a mailing address.
  • Your w-2 from last year
  • A paystub, payment statement, or tax form from last year that shows:
    • A date within the 12 months before your claim.
    • Your first name (or initial) and last name.
    • At least the last four digits of your social security number (SSN) or your employee identification number.
    • Your employer’s name.
  • If you were paid in cash, you need to submit detailed proof of your cash payments (cash deposit statements, Venmo, PayPal, receipts, etc.)

You must provide documentation for all SSNs you may have worked under.

Citizenship and immigration status do not affect eligibility of your disability and family leave benefits.

Requires all of the following:

  • A copy of the individual's Social Security Statement (SSA- 7005)
  • Proof of wages earned
  • Photo identification
  • A certified birth certificate or other official certification of the individuals birth issued by a local, state, or federal agency or foreign government entity.

Penalties

If we do not receive your address verification documents within 10 calendar days, you may:

  • Be disqualified from receiving benefits.
  • Be required to repay any benefits you were not entitled to.
  • Have to pay additional penalties as required by law.

If you disagree, you have the right to file an appeal. For more information visit the State Disability Insurance Appeals page.