×
Sign out
Your session has timed out.
Click here
to access the application.
minutes
×
Popup Window
...
×
...
...
DI / DE 2517SE
Added emails
0
Incorrect emails
0
Skipped emails
0
Add users to selection
Skip unregistered users
Drag and drop csv file with emails
Close
Import
Select a Language
Value is not selected
-- Select one --
English
Arabic
Armenian
Persian
Hindi
Japanese
Korean
Khmer
Punjabi
Russian
Chinese (Traditional)
Thai
Filipino (Tagalog)
Chinese (Simplified)
Vietnamese
SAMPLE
, this page for reference only.
Mailing Date:
Blank Line
Claim Effective Date:
Blank Line
Office Number:
Blank Line
Notice of Disability Insurance (DI) Determination
Blank Box
We are unable to pay you Disability Insurance (DI) benefits for
MM/DD/YYYY
through
MM/DD/YYYY
because:
You have received accrued leave credits from your employer for the same period covered by your
DI
claim.
Basis:
The Contract Agreement between State of California and Service Employees International Union (SEIU), Local
1000
, Article
9
, section
9.17 A7
, effective
MM/DD/YYYY
through
MM/DD/YYYY
restricts the use of combined State Disability Insurance (SDI) benefits and leave credits to not exceed your regular monthly pay.
Basis:
Government Code section
19884
: Payment of State Disability Insurance (SDI) benefit claims are made in accordance with the procedures described in the California Unemployment Insurance Code (CUIC).
Basis:
Other
Blank Line
Employment Development Department
PO Box 2168
Stockton, CA 95201-2168
Phone
1-866-352-7675
This determination is final unless you send a written appeal within
30
days from the mailing date above. You may appeal by completing the enclosed
Appeal Form
(DE 1000AA)
or separately writing a detailed statement of why you believe the determination is in error. Please include your Social Security number on your appeal and send it to the Employment Development Department (EDD) office shown above.
Select to resubmit a
DE 1000AA
(English/Spanish)
DE 2517SE Rev. 6 (9-21)
(INTRANET)
Email Address:
Back to Dashboard
Continue Editing
Send
Close