Disability Application – EDD Resources (ENGLISH)

Disability Insurance (DI)

  • If you’re unable to work due to having or being exposed to COVID-19.
  • Maximum: 52 weeks
  • Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50-$1,300 a week.
  • Need Physician/Practitioner’s Certificate
  • Waives the one-week unpaid waiting period, so you can collect DI benefits for the first week you are out of work

File a Disability Insurance (DI) claim online through SDI Online: https://www.edd.ca.gov/Disability/SDI_Online.htm

*Client must complete Part A, *Client’s Physician/Practitioner must complete Part B

When To Submit A Claim:

  • Submit the claim no earlier than nine days after the first day client’s disability begins, but no later than 49 days after client’s disability begins, or client may lose benefits.

Duplicate claims:

  • Do not submit duplicates of the same claim. This will delay claim processing.

Required Client Information for Part A

  • First and last name
  • Social Security card
  • California Driver License number.
  • Most current employer’s business name, phone number, and mailing address (as stated on the client’s W-2 or paystub).
  • Last date client worked his or her regular duties and hours or date client began working at less than full duty or modified duty.

Provide the information below ONLY if it applies:

  • Any wages client received or expect to receive from the client’s employer (sick leave, paid-time-off (PTO), vacation pay, annual leave, and wages earned after the client stopped working).
  • Any workers’ compensation claim information, if applicable.
  • If the client receives in-patient treatment at an alcoholic recovery home or drug-free facility, provide the name, address, and phone number of the home or facility. 

Physician/Practitioner Completes Part B

  • Medical Certification
    • Provide client’s Form Receipt Number to client’s physician/practitioner so they can submit the medical certification. The physician/practitioner must submit the certification no later than 49 days after client’s disability begins or client may lose benefits.

File a Disability Insurance (DI) claim online through https://www.edd.ca.gov/Disability/SDI_Online.htm

PDF version of the Application: https://www.edd.ca.gov/pdf_pub_ctr/de2501.pdf