CA PFL provides up to 8 weeks of paid leave for bonding, caregiving, or military assist

PFL is not job-protected on its own — but CFRA (California Family Rights Act) provides separate job protection

Benefits are approximately 60-70% of your weekly wages, up to the state maximum

Employment / FMLAmoderate

California Paid Family Leave Claim

DE 2501F · California Employment Development Department

Claim for Paid Family Leave (PFL) Benefits in California. Covers bonding with a new child or caring for a seriously ill family member.

Form Details

Total fields: 36
Auto-fillable: 22 (61%)
Time without BeneFill: 25 minutes
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Time saved: 18 minutes
Filled by: patient
Frequency: per incident
State-specific: Yes — form may vary by state

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Where to Submit This Form

🌐

SDI Online (recommended)

https://edd.ca.gov/en/disability/how-to-file-a-pfl-claim/

File your Paid Family Leave claim online through SDI Online.

📬

Mail to EDD

Employment Development Department PO Box 989777 West Sacramento, CA 95798-9777

Filing Deadline

File within 41 days of the start of your family leave period. Late claims may result in lost benefits.

Required Attachments

📎 Medical certification if caring for a seriously ill family member
📎 Birth certificate or hospital documentation if bonding with a new child
📎 Military assist claim documentation if applicable

Processing Time

Approximately 14 days if filed online. First payment within 2 weeks of approval.

What Happens Next

EDD will determine eligibility and send a Notice of Computation showing your weekly benefit amount. Benefits are approximately 60-70% of weekly wages.

Tips for This Form

✓ CA PFL provides up to 8 weeks of paid leave for bonding, caregiving, or military assist
✓ PFL is not job-protected on its own — but CFRA (California Family Rights Act) provides separate job protection
✓ Benefits are approximately 60-70% of your weekly wages, up to the state maximum
✓ More information: https://edd.ca.gov/en/disability/paid-family-leave/

More Employment / FMLA Forms

FMLA Certification - Employee's Serious Health Condition

WH-380-E · U.S. Department of Labor

Certification of Health Care Provider for Employee's Serious Health Condition. Medical certification for FMLA leave for the employee's own condition.

FMLA Certification - Family Member's Serious Health Condition

WH-380-F · U.S. Department of Labor

Certification of Health Care Provider for Family Member's Serious Health Condition. Medical certification when employee needs leave to care for a family member.

FMLA Notice of Eligibility and Rights & Responsibilities

WH-381 · U.S. Department of Labor

Notice of Eligibility and Rights & Responsibilities. Employer must provide within 5 business days of FMLA leave request, stating whether employee is eligible.

FMLA Designation Notice

WH-382 · U.S. Department of Labor

Designation Notice. Employer designates leave as FMLA-qualifying or denies it. Must be provided within 5 business days of receiving sufficient certification.

FMLA Certification - Qualifying Exigency (Military)

WH-384 · U.S. Department of Labor

Certification of Qualifying Exigency for Military Family Leave. For leave due to a covered family member's active duty or call to active duty.

FMLA Certification - Serious Injury/Illness of Servicemember

WH-385 · U.S. Department of Labor

Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave (current servicemember).

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the California Employment Development Department or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.