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You may submit medical certifications using SDI Online or by completing and mailing the paper claim form: Claim for Disability Insurance (DI) Benefits (DE 2501) or Claim for Paid Family Leave (PFL) Benefits (DE 2501F). For more information, visit docHub and Manage Claims Basics for Physicians/Practitioners.
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.
The disability examiner who handles your case will contact the doctors and hospitals listed on your application to request your medical records and other applicable documents. These records might serve as medical evidence to support your claim.
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.
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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To file your claim online, follow these steps: Log in to your BPO account. Select SDI Online. Select New Claim. Select Disability Insurance and follow the steps in each section. Submit the completed Part A Claimants Statement. Save your receipt number.
This form may be completed online, printed, and mailed or faxed to EDD.
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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