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To submit by US mail you must first order a claim form.
To request general program information or data about State Disability Insurance, complete the State Disability Insurance Request for Information Form DE E and return it to the Employment Development Department using the appropriate email address listed on the form.
If you have not received this form within 10 days after your disability claim re, please call Some forms and publications are translated by the department in other languages. Employers are not required to provide the PFL claim forms to their employees. When calling via the California Relay Serviceplease provide 25501f Paid Family Leave number to the operator.
PFL law requires employers to provide the Paid Family Leave – DE brochure only to new employees and employees who request leave to care for a d ill family member or bond with a new child.
New Paid Family Leave (PFL) Benefits Form Required July 1 –
These brochures may be downloaded and provided as official notices to employees. If any questions arise related to the information contained in the translated website, please refer to the English version. Forms and Publications Labor Market Information.
It cannot be downloaded or reproduced. The EDD is unable to guarantee the accuracy of this translation and is therefore not liable for any inaccurate information or changes in the formatting of the pages resulting from the translation application tool.
Any discrepancies or differences created in the translation are not binding and have no legal effect for compliance or enforcement purposes. For those forms, visit the Online Forms and Publications 250f.
To order an original form, visit Online Forms and Publicationsor call Deaf, speech impaired, and hard of hearing callers can contact PFL directly by Teletypewriter TTY this number does not accept voice calls. All are available free of charge, whether you download or order for delivery by mail. Inquiries about individual claims using this form will not be answered.
The web pages currently in English on the EDD website are the official and accurate source for the program information and services the EDD provides. You may need to download the free Adobe Reader 25001f view and print linked documents.
If you are a woman currently receiving Disability Insurance pregnancy-related benefits, it is not necessary to request a Claim for Paid Family Leave Benefits.