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Do. La incapacidad incluye la cirug a electiva, el embarazo, el parto, o las condiciones m dicas relacionadas. Alameda.......................... 1600 Harbor Bay Pkwy., Suite 120 (escriba a: PO Box 1857, Oakland, CA 94604-1857) Chico..........................................................645 Salem Street (escriba a: PO Box 8190, Chico, CA 95927-8190) Chino Hills................15315 Fairfield Ranch Road, Suite 100 (escriba a: PO Box 60006, City of Industry, CA 917160006) Fresno.

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Related content

DE 2515 - EDD - CA.gov
SDI Online will provide a receipt number once the claim is submitted. If using a paper...
Learn more
State Disability Insurance Benefits
1. Use SDI Online to securely file for benefits or request a paper claim form online. •...
Learn more

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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.

If you misplaced the DE 2525XX, request the form using your SDI Online account or by calling 1-800-480-3287. If this form is submitted late, you may lose benefits.

How Do I File for Disability? You can file the Claim for Disability Insurance (DI) Benefits (DE 2501) (PDF) claim by mail or even faster with SDI Online. Register and create an account with us through Benefit Programs Online so that you can file and manage your disability claim with SDI Online.

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.

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.

Be unable to do your regular or customary work for at least eight days. Have lost wages because of your disability. Be employed or actively looking for work at the time your disability begins. Have earned at least $300 from which State Disability Insurance (SDI) deductions were withheld during your base period.

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.

The following licensed health professionals can certify claims: Licensed medical or osteopathic physician/practitioners. Authorized medical officer of a U.S. Government facility. Chiropractor. Podiatrist. Optometrist. Dentist. Psychologist. Nurse practitioner or physician assistant.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232