As you navigate your CA EDD claim filings, you may find that you have to submit your claim(s) via paper forms. This process can be a bit confusing, so we've collated some common questions and guidance below! This article is non-exhaustive, so we always recommend reviewing the CA EDD's website as well for the most up to date guidance.
Why might I need to file via paper forms?
If you are unable to provision a CA EDD account online, you will need to file by paper mail.
You may be unable to file online for the following reasons:
You don’t have a California Driver’s License or ID
Your California Driver’s License or ID is expired
EDD is unable to register your account based on the information you’ve provided or the information provided is inaccurate
You have filed for claims or unemployment with the EDD before under a different name/maiden name or your name is too long for their systems
Your medical provider will not certify claims online
Your medical provider is not in the state of California
How does this affect the timeline of my claim?
In general, filing via paper forms will mean a significantly longer processing time than the typical two week turnaround seen with online claims. On average, paper claims see approval between 6-8 weeks post submission. However, we have facilitated some paper claims that have required upwards of three months for approval due to the CA EDD’s antiquated processes with paper mail.
If after 2-3 weeks you haven't heard anything back from the EDD, we recommend reaching out to them directly to check in on your claim status.
For guidance on contacting the EDD, please see our Contacting the CA EDD article!
How do I fill out my paper claim?
CA EDD Claim for Disability Benefits |
1. Provide HIPAA Authorization
The first section of your claim is HIPAA Authorization, which you must provide so that your medical provider can release information for your disability claim. This certification MUST be completed by a licensed medical provider.
2. Complete the Claimant's Statement section
A1: Your social security number
A2: Your historical account information (if applicable)
A3: Your CA driver’s license number (leave blank if you do not have one)
A4: Your gender
A5: Provide past information
A6: Select as applicable
A7: Your own date of birth
A8: Your First Name, Middle Initial, Last Name
A9: Other names as applicable
A10: Your own phone number
A11: Your own cell phone number
A12: Your preferred language
A13: The address you wish to receive payment
A14: Your mailing address.
Note that if it differs from your residential address, the EDD often flags this as fraud and may deny/freeze payments.
A15: Your Employer’s name - include your employer's name
Employer's address - include this address on your claim form
548 Market St #68975
San Francisco, California 94104
Please note that the employer mailing address linked to your claim is Cocoon’s office address. We use this address in order to help facilitate your claims and ensure any documentation that needs to be filled out by your employer is quickly and accurately returned to the EDD!
A16: Complete as applicable
A17: The last day you worked before going on disability leave
A18: The first day your disability began (or the first day you wish for your payments to start). Note that this day should match the first day certified by your medical provider
A19: Please provide a date if applicable
A20: Select “No” to avoid payment denial
A21: Leave blank as your medical provider will certify the day of your recovery
A22: Your personal social security number
A23: Your occupation (ie “Engineer” or “Salesperson”)
A24: Select “illness, inury or pregnancy”
A25: Select the description as applicable
A26: If your employer tops up your leave benefits, write “LSDI”. Otherwise, leave blank.
A27: Select “Yes” to ensure proper pay reconciliation with your employer
A28: Input as applicable
A29: Check as applicable
A30: Input as applicable
A31: Select as applicable. Please note that answering “Yes” may deny disability benefits
A32: Select “No”
A33: Input as applicable
A34: Input as applicable
A35: Your personal social security number
A36: Input as applicable
A40: Remember to sign and date!
3. Ask your medical provider to complete the Physician/Practitioner’s Certificate section
The physician/practitioner’s certificate must be certified by a medical provider on the original paper claim. The dates that your medical provider certifies are the dates that the CA EDD will pay out for your benefits – so make sure the dates certified by your provider match the dates of your leave plan.
If your medical provider wishes to certify online, you must first mail your “Claimant’s Statement” to the CA EDD at the address below to receive a Receipt Number. Then, give your Receipt Number to your medical provider so that they can certify your claim online. Often, certifying online will speed up the processing time.
Mailing Completed Disability Claims
Once you have completed your paper claim for disability, mail it to the following address:
State of California Employment Development Department PO Box 989777 West Sacramento, CA 95798-9777 |
Have Questions? We're here to help!
Email us at [email protected]