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The SDI Online system may adjust the employer address information to follow US Postal 
Service standards. Confirm the Updated Address section is correct by selecting Yes
Select Noto go back to the previous page and re-enter the address. 
123 Main St.
Sacramento
123 Main St.
Sacramento, CA 95814-0012
31
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On the Declaration page select 
the first check box to authorize 
an electronic signature. 
Select the second check box and 
enter the name of the 
physician/practitioner in the field. 
Both boxes must be selected to 
complete your claim. 
Select the Claim for Disability 
Insurance (DI) Benefits (DE 
2501)link to view or print your 
application for your records. 
Select Submit to finalize the 
process. 
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The Confirmation
page will provide a 
Form Receipt Number, 
which you need to give  
to your  
physician/practitioner.  
Note:Your 
physician/practitioner 
can complete the 
medical portion online 
or mail in the hard copy 
claim form, Claim for 
Disability Insurance (DI) 
Benefits, DE 2501.
Selecting the Form 
Receipt Numberlink 
will open a PDF printer-
friendly view of the 
information that was 
submitted.
33
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SDI Online Tutorial: 
Filing a Paid Family Leave (PFL) 
Bonding Claim – New Mother
34
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Once you have 
successfully 
logged into your 
account, you 
will be directed 
to the Home
page. 
To file a Paid 
Family Leave 
(PFL) bonding 
claim for new 
mothers, begin 
by selecting  
Inbox from the 
Main Menu or 
the Message 
Center. 
Jane Doe
000-00-0000
000-000-0000
000-000-0000
123 Main St.
123 Main St.
35
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In your Message 
Center, select the 
Form DE 2501 FP 
Claim for Paid 
Family Leave (New 
Mother) link that will 
be sent to you when 
your pregnancy 
disability claim ends.
36
Jane Doe
01-07-1990
04-07-2015
04-27-2015
Jane Doe
01-07-1990
04-07-2015
Jane Doe
01-07-1990
Jane Doe
01
-
0
7
-
1
9
90
01-07-1990
Jane Doe
01-07-1990
When the message 
opens, select the 
Forms Available to 
Submit linkto file a 
claim.
If you did not have a 
disability pregnancy 
claim, please refer to 
Filing a Paid Family 
Leave (PFL) 
Bonding Claim, 
New Father, 
Adoption, or Foster 
Care section of the 
tutorial.
37
DI-1000-111-123
04-07-2015
38
Jane Doe
DI-1000-111-123
Select the Paid 
Family Leave 
Bondinglink.
Answer the prescreening questions: 
• If you are a new mother applying for bonding benefits and are transitioning from a 
Disability Insurance pregnancy claim, select Yesfor both questions. 
• If you are a new mother applying for bonding benefits and did not file a Disability 
Insurance pregnancy claim, select Yesfor the first question and Nofor the second 
question. Refer to the “SDI Online Tutorial: Filing a Paid Family Leave Bonding Claim –
New Father, Adoption, or Foster Care” for more information.
• If you are a new father applying for bonding benefits, or a parent applying for bonding 
with an adopted or foster child, select Nofor both questions and refer to the “SDI 
Online Tutorial: Filing a Paid Family Leave Bonding Claim – New Father, Adoption, or 
Foster Care” for more information.
Once the two questions have been answered, select Next.
39
Information from 
your SDI Online 
account will 
automatically 
populate portions 
of the PFL claim 
form. 
Verify the 
information and 
complete any 
open fields, as 
appropriate. 
Then select Next
Jane Doe
123 Main St.
Anytown, CA 95814-4504
916-555-1212
1234567891
40
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