Disability Insurance - Forms and Publications

En español

The forms and publications on this website are in Adobe’s Portable Document Format (PDF). You may need to download the no-cost Adobe Reader to view and print linked documents.

To search and order brochures and forms from the EDD, visit Online Forms and Publications. All are available at no cost, whether you download or order for delivery by mail.

Forms

  • Claim for Disability Insurance (DI) Benefits (DE 2501) – English

    Claimants must submit an original form provided by the EDD, either electronically or through US mail. It cannot be downloaded or reproduced.

    To submit the DE 2501 electronically, visit How to File a Disability Insurance (DI) Claim in SDI Online.

    To submit by US mail, visit How to File a Disability Insurance (DI) Claim by Mail.
  • Physician/Practitioner’s Supplementary Certificate (DE 2525XX)
    If your disability will extend beyond the original period established on your claim, have your physician/practitioner complete and submit the DE 2525XX online using SDI Online. To submit by US mail, you must first order the form by calling 1-800-480-3287 or 1-866-658-8846 (en español).

To request general program information or data about State Disability Insurance, complete the State Disability Insurance Request for Information Form (DE 2541E) and return it to the Employment Development Department using the appropriate email address listed on the form. If your printer has a problem printing the above form, try the Shrink to Fit check box under the Acrobat Reader’s print function.

Note: Inquiries about individual claims using this form will not be answered.

Publications