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You can get a paper Claim for Disability Insurance (DI) Benefits (DE 2501) form by: Ordering a form onlineto have it mailed to you. Getting the form from your licensed health professional or employer. Visiting an SDI Office. Calling 1-800-480-3287 and selecting DI Information option 3 to request a paper form by mail.
This form may be completed online, printed, and mailed or faxed to EDD.
Visit Online Forms and Publications. Select Keyword(s) or Form Number from the dropdown. Enter DE 2501 for an English form or DE 2501/S for a Spanish form. Select Search.
Submit Your Documents Recommended: Log in to your UI Online account and go to the Upload Income Documents for PUA section on the homepage to provide the required documents. If you prefer to mail your documents, write your 10-digit EDD Customer Account Number (EDDCAN) clearly at the top of each page.
For Disability Insurance claims, fill out and sign Part B Physician/Practitioners Certificate on the Claim for Disability Insurance (DI) Benefits (DE 2501) form. Mail it in within 49 days from the date your patients disability begins.
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You can get a paper Claim for Disability Insurance (DI) Benefits (DE 2501) form by: Ordering a form onlineto have it mailed to you. Getting the form from your licensed health professional or employer. Visiting an SDI Office. Calling 1-800-480-3287 and selecting DI Information option 3 to request a paper form by mail.

ca state disability form