All three parts of this claim form must be completed to reduce delays in processing this claim 2025

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For Disability Insurance claims: Fill out and sign Part B Physician/Practitioners Certificate on the Claim for Disability Insurance (DI) Benefits (DE 2501). Mail it to us within 49 days from the date your patients disability begins.
Respond to Us for Employee Claims Notice to Employer of Disability Insurance Claim Filed (DE 2503) Sent to you after the employee files a DI claim. You can use SDI Online or the paper form to verify the employees information on their claim. You must complete and return the form to us within two working days.
How to fill out a DE 2501 form? Start by entering your personal information including name, address, and social security number. Detail your employment history and income for the last 18 months. Specify the reason for your claim and the last day worked. Include doctors information if your claim is for disability.
It takes about three weeks to process a new application for unemployment benefits and issue payment to eligible workers. Visit Benefit Payment Options for more information on direct deposit, debit card, or mailed checks.
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