Get Continuing Disability ClaiM ForM FaX To...

Supporting Documentation Needed ✓ Chart Note to include admission and discharge paperwork if there was a hospital stay ✓ Surgical Report if surgery took place ✓ Receipts for follow up visits or physical therapy with dates and charges if applicable ✓ Email form to groupclaimfiling@aflac.com or fax to 1.866. 849.2970.

English: 1-800-480-3287. Spanish: 1-866-658-8846. California Relay Service (711): Provide the DI number (1-800-480-3287) to the operator. TTY: 1-800-563-2441.

Mail it to the address on the application. We recommend Certified Mail, Return Receipt Requested. Fax to 518-474-3091.

By mail: EDD, Disability Insurance, PO Box 989777, West Sacramento, CA 95798-9777. In person by visiting any of the DI offices listed under “DI Office Locations.” California state government employees covered by SDI should call 1-866-352-7675. 2.

By mail: EDD, Disability Insurance, PO Box 989777, West Sacramento, CA 95798-9777. In person by visiting any of the DI offices listed under “DI Office Locations.” California state government employees covered by SDI should call 1-866-352-7675. 2.

Claim for Disability Insurance (DI) Benefits (DE 2501) – English: You must submit an original form provided by the EDD, either electronically or through US mail. It cannot be downloaded or reproduced. To submit the DE 2501 electronically, visit How to File a Disability Insurance Claim in SDI Online.

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.

To search and order brochures and forms from the EDD, visit Online Forms and Publications. All are available at no cost, whether you download or order for delivery by mail.