Basics for Physicians-Practitioners
Physicians/Practitioners that can certify claims for Disability Insurance (DI) or Paid Family Leave (PFL):
- Licensed medical or osteopathic physician/practitioners
- Authorized medical officer of a U.S. Government facility
- Nurse Practitioner or Physician Assistant after examination and collaboration with physician and/or surgeon
- Licensed midwife, nurse-midwife, or nurse-practitioner for normal pregnancy or childbirth
- Accredited religious practitioner
We review claims to ensure that all eligibility requirements are met; this includes verification of your physician/practitioner license. Your license must be active and in good standing. Both you and the patient must certify that the information provided is complete and accurate.
Properly completed claims are generally processed within two weeks of our receipt.
State Disability Insurance (SDI) Online
SDI Online provides customers with electronic and automated options that are simple to use and available 24 hours a day, 7 days a week.
SDI Online is convenient and secure. The system reduces claim processing time, provides immediate electronic confirmation of forms submitted, decreases costs in paper and postage, and includes security safeguards to detect and manage fraud and abuse.
Physicians/Practitioners can view patient’s initial claim for benefits, submit DI and PFL claim certifications, and view claim certification history.
To register for SDI Online:
If you are registered, log in to SDI Online:
Tips for Completing a Disability Insurance Claim
The Claim for Disability Insurance (DI) Benefits (DE 2501) is designed with Optical Character Recognition (OCR) functionality allowing information you enter to be scanned and uploaded automatically to SDI Online. To avoid delays in claims processing, please complete the form as follows:
- Use black ink only.
- Type or write clearly within the boxes provided.
- Fill out only the physician/practitioner’s portion of the form (Part B).
- Complete and sign “Part B – Physician/Practitioner’s Certificate” and submit within 49 days from the date your patient’s disability begins. Failure to do so may cause your patient’s benefits to be denied.
- Do not fax the form.
- Mail the completed form to the EDD in the pre-addressed envelope provided.
Do not mail this form to the EDD if you have already submitted the claim online.
Causes of Delays
If any of the following requirements are missing, processing will be delayed:
- Physician/Practitioner’s original signature.
- Physician/Practitioner’s license number.
- Estimated date the patient will be able to return to his/her regular or customary work.
- Diagnosis and ICD9 code, (If a diagnosis has not been established, a detailed statement of disabling symptoms must be provided.)
- Patient’s signature.
- Patient’s name and address.
- Patient’s employment information.