How to Apply for Disability Insurance Elective Coverage

To determine if you are eligible to elect Disability Insurance Elective Coverage (DIEC), please read the Information Sheet: Elective Coverage for Employers and Self-Employed Individuals (DE 231EC) prior to filling out the application. If you have questions regarding your eligibility and would like to speak with a DIEC Customer Service Representative, call 916-654-6288, or the toll-free Taxpayer Assistance Center at 888-745-3886, or (non-voice) TTY 1-800-547-9565.

Offices are open between the hours of 8 a.m. and 5 p.m., Monday through Friday excluding holidays.

Apply for Disability Insurance Elective Coverage

If you would like an application, you can download or order it through the Online Forms and Publications page or call 916-554-7104.

If you are covered by DIEC and need to file a Disability Insurance benefit claim form, see the Disability Insurance claim page. If you need to file a Paid Family Leave benefit claim form, see the Paid Family Leave claim page.