Get CA DE 2501F 2019-2021

You can submit Part D - Physician/Practitioner's Certification online by creating a Benefit Programs Online (BPO) account and registering for SDI Online. Once registered, select SDI Online to complete the certification for your patient's caregiver's claim from the home page.

Email VP2523@edd.ca.gov to: Resolve hardship disputed coverage claim issues. Submit the Report of Voluntary Plan Claim (DE 2523) (PDF), if not registered in SDI Online.

You can also contact EDD representatives at 1-800-480-3287 for Disability Insurance or 1-877-238-4373 for Paid Family Leave, from 8 a.m. to 5 p.m., Monday through Friday.

Visit Online Forms and Publications and order a form online. A form will be mailed to you. Obtain the form from your physician/practitioner or employer. Visit an SDI Office. Call 1-877-238-4373. California Relay Service (711) Provide the PFL number (1-877-238-4373)

Fax your application to the number listed on the form. You can contact your local America's Job Center of California for help with faxing your paper application. Tip: The fastest way to apply is through UI Online.

Benefits are paid for a maximum of six weeks (set to increase to eight weeks on July 1, 2020). The seven-day waiting period no longer applies, so benefits can begin with the first day off work.

PSA for CA EDD folks: if you've been asked to mail in docs to verify your identity, faxing them to 916-653-2734 worked for me.

Mail your claim form in the pre-addressed envelope. If you do not have the pre-addressed envelope provided with the claim, send your claim and correspondence to: EDD-Paid Family Leave, PO Box 989315, West Sacramento, CA 95798-9315.

The PFL program is 100% funded entirely through worker contributions to the State Disability Insurance program. Employers do not have to pay employees' salaries while they are on leave. Many small businesses that cannot afford to offer paid leave to their employees can offer the benefit through the PFL program.

Fax: 916-262-2352. California Relay Service (711): Provide the Labor Market Information number (916-262-2162) to the operator.