To view an example DI claim form for reference only, review the DE 2501 – Sample claim form or the DE 2501/S – Spanish sample claim form. Enter DE 2501 for an English form or DE 2501/S for a Spanish form.Select Keyword(s) or Form Number from the dropdown.To submit by US mail, visit How to File a Disability Insurance Claim by Mail.
To submit the DE 2501 electronically, visit How to File a Disability Insurance Claim in SDI Online. All are available at no cost, whether you download or order for delivery by mail. To search and order brochures and forms from the EDD, visit Online 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.
