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Claim for Paid Family Leave (PFL) Benefits Paid Family Leave (PFL), a workerfunded program, provides benefits to eligible workers who have a full or partial loss of wages due to the need to care for.

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How to fill out the CA DE 2501F online

Completing the CA DE 2501F form for Paid Family Leave benefits can seem daunting, but following a clear process can help simplify this important task. This guide provides a comprehensive walkthrough of each section of the form, ensuring you can fill it out accurately and efficiently.

Follow the steps to complete your form confidently.

  1. Click ‘Get Form’ button to obtain the form and access it in your editor.
  2. Begin by completing all items in 'Part A – Statement of Claimant.' Ensure you provide your legal name, Social Security number, and contact information. Sign in the designated area to confirm the information provided is true and accurate.
  3. If filing for bonding with a new child, proceed to 'Part B – Bonding Certification.' Here, you will need to specify if the child is your biological, adopted, or foster child, and include the child's Social Security number if available.
  4. For those filing to care for a seriously ill family member, have the care recipient sign the 'Care Recipient's Authorization for Disclosure of Personal-Health Information' on page 2, authorizing you to request necessary information from their medical provider.
  5. In 'Part C – Statement of Care Recipient,' complete the required fields with the care recipient's details. Ensure they sign the section confirming their authorization.
  6. The treating physician or practitioner must complete 'Part D – Physician/Practitioner's Certification.' This includes diagnosing the care recipient's condition and confirming the need for care. A physical signature is required; rubber stamps are not accepted.
  7. Decide on the effective date for your claim, which can impact your benefit amount. Review the instructions for guidance on dating your claim accurately.
  8. Once all parts are complete and signed, place the forms into the provided envelope. Claims are typically processed within 14 days once the EDD has received a fully completed claim.
  9. Keep a copy of all forms and instructions for your records. After submission, you can track the status of your claim as needed.

Complete your CA DE 2501F form online today to ensure timely processing of your Paid Family Leave benefits.

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

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.

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.

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.

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.

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.

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)

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.

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 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.

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