Get De 2587 Disability Form

For Disability Insurance claims, fill out and sign Part B – Physician/Practitioner's Certificate on the Claim for Disability Insurance (DI) Benefits (DE 2501) form. Mail it in within 49 days from the date your patient's disability begins.

Downloading and Printing The forms are in Portable Document Format (PDF). You may need to download the no-cost Adobe Reader to view and print linked documents.

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 Certify 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.

If you are on automatic payment, you will receive a Disability Claim Continued Eligibility Questionnaire (DE 2593) after 10 weeks of payment. You must return this form to us to certify that your disability continues. Your benefits will stop if you do not complete and return the DE 2593.

Most benefits are issued within two weeks after a completed claim is received. There is a seven-day, non-payable waiting period for Disability Insurance (DI) benefits. Benefits start on the eighth day. If you are eligible, the EDD processes and issues payments within a few weeks of receiving a claim.

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.