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About De 2501f

DE 2501F is a medical certification form that is required by the State of California Employment Development Department (EDD). It is commonly known as the "Claim for Disability Insurance Benefits" form. This form is necessary for individuals who are unable to work due to a non-work-related illness, injury, or pregnancy-related disability and need to apply for disability benefits in California. The DE 2501F form serves as a medical certificate and must be completed by a licensed healthcare provider (doctor, physician assistant, nurse practitioner, etc.) or a licensed midwife for pregnancy-related disabilities. The healthcare provider needs to provide a detailed diagnosis, treatment, and expected duration of the disability to determine the eligibility of the claimant for disability benefits under the State Disability Insurance (SDI) program. Once completed, the DE 2501F form needs to be submitted to EDD along with other required documents to initiate the claim process for temporary disability benefits.

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Instructions and Help about De 2501f

Paid Family Leave provides benefits payments so you can take time off to care for   a seriously ill family member, bond with  a new child, participate in a qualifying   event because of a family member's  military deployment to a foreign country. You can apply for Paid Family Leave using SDI Online at    or by mail. If you choose to apply by  mail, there are four ways to get a claim for   Paid Family Leave Benefits (DE 2501F) form. Order the DE 2501F online and have it mailed to you.   Visit Select  keywords or forms number. Enter 2501F and   select search. Enter one in the quantity  box next to DE 2501F and select add to cart.   Select checkout and complete your mailing information to order your form.   Get the form from your licensed health professional or employer. Find an SDI Office near you by visiting  and select disability insurance offices. Call 1-877-238-4373 to request a form by mail. You cannot print and mail the DE 2501F from the   website. You must choose one of the four options available to receive the form. Step one: Get your information in order.   Full name. Social security number. Current employer's business name, phone number and mailing address as stated on your W-2 or pay stub. Last date you worked your normal hours. You may also need any wages you received or expect to receive from your employer.   This could be sick leave, paid time off or  PTO, vacation pay, annual leave and wages earned after you stopped working. Any workers compensation claim information.   Proof of relationship for bonding claims. Statement of care recipient and physician or practitioner certification for care claims. Military assist documentation. Step two: Fill out Part A - Statement  of Claimant of the DE 2501F form.   You are responsible for filling out Part A of the form. You may also need to complete additional   sections and provide...