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How to Apply for Disability Insurance Elective Coverage

To determine if you are eligible to elect Disability Insurance Elective Coverage (DIEC), please read information sheet: Elective Coverage for Employers and Self-Employed Individuals (DE 231EC) prior to filling out the application. If you have questions regarding your eligibility and would like to speak with a DIEC Customer Service Representative, call (916) 654-6288, or toll-free Taxpayer Assistance Center at (888) 745-3886, or (non-voice) TTY 1-800-547-9565.

Offices are open between the hours of 8 a.m. and 5 p.m., Monday through Friday excluding holidays.

Apply for Disability Insurance Elective Coverage

If you would like an application, you can download the application, order it online, have it faxed to you via Fax on Demand at (877) 547-4503 (Document Nos. 1370 and 3090, respectively), or call (916) 554-7104.

If you are covered by DIEC and need to file a Disability Insurance benefit claim form, see how to file a Disability Insurance claim. If you need to file a Paid Family Leave benefit claim form, see how to file a Paid Family Leave claim.