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Claim for Disability Insurance (DI) Benefits (DE 2501) – English: You 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 Claim in SDI Online.
- Claim by Mail
You can get a paper Claim for Disability Insurance (DI)...
- Forms and Publications
The documents on this webpage are PDFs. To complete forms,...
- Paid Family Leave
To view an example PFL claim form, review the DE 2501F –...
- Claim for Disability Benefits
The State Disability Insurance (SDI) program provides...
- Claim by Mail
The State Disability Insurance (SDI) program provides benefits to eligible workers who have a full or partial loss of wages due to disabilities that are not work related. A disability is any illness or injury, either physical or mental, that prevents you from doing your
The PDFs on this website are replicas of the official EDD forms and publications. To complete forms, you may need to download and save them on the computer, then open them with the no-cost Adobe Reader. Visit Online Forms and Publications to search, view, and order State Disability Insurance forms. SDI Forms and Publications
For faster processing, complete and submit this form online at www.edd.ca.gov. If you submit online, do not mail this form to the Employment Development Department (EDD).
California Employment Development Department (EDD) all facts concerning my disability that are within their knowledge and to allow inspection of and provide copies of any medical, vocational rehabilitation, and billing records concerning my disability that are under their control.
Form DE 2501, Claim for Disability Insurance (DI) Benefits, is a form to request, by mail, worker-funded benefits to eligible workers who have a full or partial loss of wages due to disabilities that are not work-related. Alternate Name: California Disability Form.
Development Department (EDD): Disability Insurance Branch examiners, their direct supervisors/managers and any other EDD employee who may have a need to access this information in order to process my claim and/or determine eligibility for State
