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Getting the form from your physician/practitioner or employer. Visiting an SDI Office. Calling 1-800-480-3287 to request a paper form by mail.
Getting the form from your physician/practitioner or employer. Visiting an SDI Office. Calling 1-800-480-3287 to request a paper form by mail.
Claim for Disability Insurance (DI) Benefits (DE 2501) \u2013 English: You must submit an original form provided by the EDD, either electronically or through US mail. It cannot be downloaded or reproduced.
The California Disability form was issued by the Employment Development Department on April 1, 2019. A printable DE 2501 Claim Form is available for download below.
File by Mail 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 licensed health professional's original signature. Include licensed health professional's license number.

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Mail: To file a claim with the EDD by mail, complete and submit a Claim for Disability Insurance (DI) Benefts, DE 2501 form. You can obtain a paper claim form from your employer, physician/practitioner, visiting a State Disability Insurance office, online at www.edd.ca.gov/Forms, or by calling 1-800-480-3287.
For more EDD forms and publications, visit Online Forms and Publications. The documents on this website are PDFs. To complete forms, you may need to download and save them on the computer, then open them with the no-cost Adobe Reader.
If your claim is on automatic payment, after 10 weeks of payment, you will receive a Disability Claim Continued Eligibility Questionnaire (DE 2593). Return the form to the EDD either by mail or through your SDI Online account to certify that your disability continues.
Have your physician/practitioner complete and submit this form to find out if you are eligible for an extension. Your physician/practitioner can find your claim in SDI Online. The DE 2525XX must be returned to us online or by mail within 20 days from the mailing date.
Physician/Practitioner's Supplementary Certificate (DE 2525XX): If your disability will extend beyond the original period established on your claim, have your physician/practitioner complete and submit the DE 2525XX online using SDI Online.

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