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EDD DE 2525XFA: PFL Supplemental Claim Certification

When a California Paid Family Leave care claim needs to continue past the period originally certified, EDD issues this supplemental certification so the care recipient's physician or practitioner can confirm care is still needed. It reaches the provider either through SDI Online or as the paper form the claimant receives with the final payment, and it determines whether PFL benefits continue.

Who completes it

The care recipient's licensed physician or practitioner completes the Physician/Practitioner's Supplementary Certificate section, answering questions 1 through 4, and signs and dates it with license number and phone number.

Submitting and payment

How to submit it
Submit it in SDI Online through myEDD, or return the paper form the patient received in the mail with the final payment. It must be returned within 20 days of the mailing date.

Good to know

  • There is no blank to download: EDD issues the form per claim, and the PFL claim ID (PFL plus 10 digits) is used to locate it in SDI Online.
  • Do not attach extra documents; EDD asks providers to write any notes on the form itself, since attachments are handled manually and delay the claim.
  • Online submission requires a one-time myEDD registration as a physician or practitioner, ID.me verification, and a license from the California Department of Consumer Affairs.
  • Its disability insurance counterpart is the DE 2525XX, used when a claimant's own disability lasts beyond the original estimate.

Get the official form

Download the current version from the source each time; forms change without notice.

Paid Family Leave (PFL) Supplemental Claim Certification (Physician/Practitioner's Supplementary Certificate)

Official page

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

See how Vero Documents works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

How long does a provider have to return the DE 2525XFA?

EDD says the DE 2525XFA must be returned within 20 days of the mailing date. Filing it through SDI Online avoids mail time, and incomplete or late certifications can hold up the continuation of the claimant's Paid Family Leave benefits.

Can the DE 2525XFA be completed online?

Yes. A physician or practitioner registered in SDI Online through myEDD can complete the supplemental certification there instead of using the paper copy mailed to the patient. Registration needs ID.me verification and a California Department of Consumer Affairs license; out-of-state providers contact EDD before registering.