- About the Program
- Eligibility
- How to File a Claim
- Forms and Publications
- SDI Contribution Rates
- Benefit Overpayments
- Legal References
- Appeals
- Future Disability Insurance Automation
- Report Fraud
Contact SDI
Education and Outreach
Disability Insurance - Forms and Publications
En EspañolYou may need to download the free Adobe Reader to view and print linked documents.
Fill-In Forms
- Use a Computer to Fill In Forms
- DE 945, Annual Income Report for Disability Insurance Elective Coverage
- DE 2501, Claim for State Disability Insurance (SDI) Benefits
The online version of the DE 2501 may be filled-in and printed. To order claim forms, use the Request A Claim Form for State Disability Insurance Benefits or call 1-800-480-3287 or 1-866-658-8846 (En Español). - DE 2523, Report of Voluntary Plan Claim
- DE 2568V, Annual Report of Self-Insured Voluntary Plan Transactions as required by California Code of Regulations, Title 22, Section 3267-2
Forms
publications are listed separately below)- DE 945 - Rev. 3 (12-05) - Annual Income Report for Disability Insurance Elective Coverage
- DE 1378DI - Rev. 41 (2-05) - Application for Disability Insurance Elective Coverage -
Note: If your printer has a problem printing the above form, try the "Shrink to Fit" check box under the Acrobat Reader's print function.
Publications
(forms are listed separately above)- Notice to Employees
- DE 1857A - Rev. 38 (2-06) - English
- DE 1857A/C - Rev. 38 (2-06) - Chinese
- DE 1857A/S - Rev. 38 (2-06) - Spanish
- DE 1857A/V - Rev. 38 (2-06) - Vietnamese
- Notice to Employees - (Employers Note: This poster is required to be posted in the workplace of employees who are covered only by State Disability Insurance. If your employees are covered by Unemployment Insurance, please post the DE 1857A.)
- DE 1858 - Rev. 3 (10-03) - English
- DE 1858/S - Rev. 3 (10-03) - Spanish
- DE 2040 - Rev. 3 (8-07) - Employer's Guide to Voluntary Plan Procedures
- DE 2501/S - Rev. 77 (3-06) - Claim for State Disability Insurance (SDI) Benefits - Facsimile and Instructions - Spanish
- State Disability Insurance Provisions (For Disabilities Beginning on or After January 1, 2003) - Bulk orders (25 or more) see Internet Order Form
- DE 2515 - Rev. 55 (12-07) - English
- DE 2515/S - Rev. 55 (12-07) - Spanish
- DE 2548 - Rev. 3 (3-07) - The Medical Provider’s Guide to DI
- Disability Insurance Elective Coverage - Bulk orders (25 or more) see
Internet Order Form
- DE 2565 - Rev. 11 (1-08) - English
- DE 2565/S - Rev. 11 (1-08) - Spanish
- DE 2588 - Rev. 4 (1-08) - State Disability Insurance (SDI) and Paid Family Leave (PFL) Weekly Benefit Amounts
- DE 2589 - Rev. 1 (1-08) - State Disability Insurance (SDI) and Paid Family Leave (PFL) Weekly Benefit Amounts in Dollar Increments
- Fact Sheets (PDF)
- DE 8714C - Rev. 31 (6-08) - Disability Insurance Program - English
- DE 8714C/S - Rev. 31 (6-08) - Disability Insurance Program - Spanish
- DE 8714CC - Rev. 15 (3-08) - Disability Insurance Elective Coverage Program - English
- DE 8714CC/S - Rev. 15 (3-08) - Disability Insurance Elective Coverage Program - Spanish