A guide for clinic staff helping patients with leave and pay

This guide explains California leave and pay programs for clinic teams. It is general information, not legal or medical advice. For the patient's side of the same process, link them to Disability and Paid Family Leave: pay and papers.

Why does this matter for my patients?

Three different things protect a patient who must miss work. Patients often confuse them, and each may need something from you.

SDI and PFL pay, but do not protect the job (EDD). Patients usually need both pay and job protection, so they may need two kinds of paperwork.

Who can certify an SDI or PFL claim?

EDD lists these licensed professionals, with an active license in good standing (EDD, Certify or Extend Claims):

• Medical and osteopathic physicians, and authorized medical officers of U.S. government facilities
• Nurse practitioners and physician assistants
• Licensed midwives and nurse midwives
• Chiropractors, podiatrists, optometrists, dentists and psychologists
• Accredited religious practitioners, who use separate forms (DE 2502 or DE 2502F)

Midwives, nurse midwives and nurse practitioners may certify only pregnancy, childbirth or postpartum conditions, within their scope of practice. Providers licensed outside California should call 1-855-342-3645 before registering.

How do I certify a disability claim?

Online (fastest). Register once with myEDD and SDI Online. EDD says this requires a California Department of Consumer Affairs license and ID.me identity check. Find the claim with the patient's receipt number (an "R" and 15 digits) or the last four digits of their SSN, plus their last name and birth date. Then submit the physician/practitioner certificate (EDD).

On paper. Complete Part B of the DE 2501 and mail it in the pre addressed envelope. EDD asks for black ink, no correction tape, labels, stamps or strikeouts, and no "NA." Include your full license number with no spaces, a wet signature and the date.

What to include:

• The primary diagnosis and its code
• An estimated recovery date. Do not write "unknown" or "indefinite."
• If recovery will take longer than usual for the diagnosis, explain why. EDD says a clear explanation can prevent a follow up call or an independent medical exam.
• Whether the condition was caused or made worse by the patient's regular work. If so, workers' compensation may apply.

Do not certify twice. If you certified online, do not also mail paper. Duplicates delay the claim.

Deadlines. Certification is due within 49 days of the start of the disability. Late certifications can lead to a denial.

Extensions. If the patient is still unable to work after your recovery date, complete the extension form (DE 2525XX for disability) and return it within 20 days. Write notes on the form instead of attaching records. Attachments slow processing.

How do I certify a family care claim?

When a patient's family member is seriously ill, the family member's provider certifies the claim on DE 2501F Part D, online or by mail. The certification states the patient's illness or injury and the reason care is needed (EDD, Physicians and Practitioners).

• Include an estimate of how much time the caregiver needs to give care.
• For PFL, the provider, the patient and the caregiver all sign. The care recipient signs an authorization.
• The deadline is 41 days from when family leave begins.
• Extensions use DE 2525XFA.

PFL pays for up to 8 weeks in a 12 month period (EDD). Family can include parents, children, spouses, registered domestic partners, siblings, parents in law, grandchildren and grandparents (EDD PFL FAQ). The family member can live outside California, but EDD must verify an out of state provider's license.

For the patient's guide, see Paid Family Leave to care for a sick family member.

What should I know for pregnant patients?

• Disability pay around birth. EDD's overview says pregnancy disability usually covers up to 4 weeks before birth and typically 6 weeks after a vaginal birth or 8 weeks after a cesarean, longer with complications (EDD overview, August 2026). Certify the dates that fit your patient.
• Bonding pay. After the disability claim ends, EDD mails a PFL claim form for bonding. Bonding needs no provider certification.
• Job protection. Pregnancy Disability Leave covers up to 4 months at employers with 5 or more employees (CRD). The employer may ask for a certification. Then CFRA can add up to 12 weeks of bonding leave for eligible workers.
• Prenatal visits. Patients can use paid sick days for preventive care (Labor Commissioner).
• Pregnancy loss. California gives up to 5 days of reproductive loss leave, and no documentation is required (CRD fact sheet). See Time off after a miscarriage or pregnancy loss.

Full patient guide: Pregnant and working: leave and pay in California.

What can an employer ask for in a leave note?

Less than many people think. This protects your patient's privacy.

Pregnancy Disability Leave. A certification should state that the employee needs leave because of pregnancy, childbirth or a related condition, the date the disability began, and its estimated length (2 CCR 11050). The employer may not ask for more than the rules allow. The regulation includes a sample form you can use.

CFRA leave. For an employee's own serious health condition or a family member's, the employer may not ask for symptoms or a diagnosis beyond what the rules allow. The employee usually gets at least 15 calendar days to provide a certification. The employer may contact you only to authenticate the note (2 CCR 11091).

Tip: do not write a diagnosis on a note to the employer unless the patient asks you to and understands who will see it. The EDD form is different: it goes to EDD, not the employer.

What should a work accommodation note say?

Sometimes a patient can keep working with a change: more breaks, a stool, less lifting, a schedule change, time for appointments, or a place to pump milk.

• Pregnancy: employers with 5 or more employees must reasonably accommodate pregnancy, childbirth or a related condition when the request comes with a provider's advice (Gov Code 12945). Federal law covers employers with 15 or more employees (EEOC, Pregnant Workers Fairness Act).
• Disability: a note can describe a medical condition that limits major life activities and the change needed.

A useful note:

1. Says you are the patient's treating provider
2. States that the patient has a condition that limits activities (the diagnosis is optional and private)
3. Lists the specific changes needed, like "may sit as needed" or "no lifting over 20 pounds"
4. Gives how long the need will last
5. Is on letterhead, signed and dated

Lactation: in California, no medical note is required for lactation breaks (Labor Commissioner).

Patient guides: Asking for changes at work while pregnant or breastfeeding and Asking for changes at work because of a disability or health condition.

How can I help immigrant patients?

Many immigrant workers pay into SDI and do not know they can claim it.

• Status does not matter. EDD says citizenship and immigration status do not affect SDI or PFL eligibility (EDD). EDD also says these benefits will not affect a path to citizenship (EDD undocumented workers page).
• No SSN? The patient files on paper, not online. They order the form from EDD, or get it from you or their employer. A patient without their own SSN leaves Question A1 blank and attaches a letter and proof of wages (EDD). Online certification uses the receipt number or SSN digits, so for paper claims, complete Part B on the paper form.
• Keep paper forms on hand. EDD lets doctors' offices supply the DE 2501 and DE 2501F. The English forms cannot be downloaded.
• Interpreters. EDD offers free interpreters by phone: DI 1-800-480-3287, PFL 1-877-238-4373, then press or say 3 (EDD).
• Cash wages. Patients paid in cash need proof, like bank deposits or payment app records. Point them to Disability and Paid Family Leave: pay and papers.
• Immigration worries. Patients worried about how any benefit affects an immigration case should ask a legal clinic. See Will using benefits hurt my immigration case?

What mistakes should clinic teams avoid?

• Missing the deadline. A late certification can mean a denial. Build EDD forms into your workflow.
• "Unknown" recovery dates. Give your best estimate. You can extend later.
• Sending a diagnosis to the employer. It is usually not required.
• Telling a patient they do not qualify because of status. Status does not affect SDI or PFL.
• Forgetting job protection. Remind patients that SDI pays but does not hold their job. They should also ask their employer for PDL or CFRA leave.

Where can patients get help?

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• EDD Disability Insurance: 1-800-480-3287 (Spanish 1-866-658-8846). Paid Family Leave: 1-877-238-4373 (Spanish 1-877-379-3819). Monday to Friday, 8 a.m. to 5 p.m. (EDD)
• Legal Aid at Work, Work and Family Helpline (California): 800-880-8047, outside California 415-593-0033. Free; callbacks usually in 2 to 3 business days.
• Legal Aid at Work Workers' Rights Clinic (East Palo Alto line): (415) 404-9093.
• Civil Rights Department (for leave or accommodation denied): 800-884-1684 (calcivilrights.ca.gov).

Questions clinic staff ask

Can a medical assistant fill out the form? Staff can help gather information, but the licensed provider must certify and sign. EDD requires your license number and signature.

The patient's employer sent its own form. Must we use it? For PDL, the employer may use its own form, the sample state form, or your provider's form (2 CCR 11050). Whatever form it is, the employer cannot ask for more than the rules allow.

What if EDD calls us? EDD may contact you if recovery looks longer than expected. Answer promptly to avoid delays for the patient.

Can we certify for a patient in another state? Out of state providers can certify after calling EDD at 1-855-342-3645.

Is there a checklist I can print?