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Click ‘Get Form’ to open the de 2501 form in the editor.
Begin with 'PART A – CLAIMANT’S STATEMENT'. Fill in your personal information, including your name and Social Security number. Ensure all fields are completed accurately to avoid delays.
Decide on the start date for your claim carefully, as it affects your benefit eligibility. Refer to Question A19 for guidance.
If you have a physician, provide them with 'PART B – PHYSICIAN/PRACTITIONER’S CERTIFICATE' for completion. This section must be signed by a licensed medical professional.
Review all entries for accuracy before submitting. If mailing, ensure you send it no later than 49 days after your disability begins.
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