Getting CA disability forms for elective surgery in Mexico - will EDD cover it?

You need what's called a DE 2501 form (Claim for Disability Insurance Benefits). You can get it directly from the SDI website under "Forms and Publications" but its kinda buried in there. As for Mexico doctors... I THINK they'll accept it but the doctor needs to be licensed. The form asks for their license number and contact info. My friend had surgery in Canada last yr and got approved but Mexico might be different????

I can provide some clarification on this. For out-of-country medical procedures, EDD does accept medical certifications from licensed physicians in other countries, including Mexico. However, there are important requirements to meet: 1. Your doctor must complete the standard DE 2501 Claim form and Part B of the form (the Physician/Practitioner Certification) 2. The doctor's medical license number must be provided 3. All documentation must be translated to English if originally in Spanish 4. The procedure must be medically necessary (even if elective) You can find the form by logging into your SDI Online account, clicking on "Forms and Publications," then selecting "Disability." The DE 2501 should be listed there. You'll need to print it out for your doctor to complete by hand.

my cousin did something like this in tijuana last summer and edd gave her the runaround for like 2 months saying they needed more info from her doctor... she finally got paid but it was a huge hassle. good luck!

yeah she got approved but only after her doctor sent like 3 different letters with more medical details. they kept saying they needed clarification on why the surgery was necessary even tho it was all on the original form

I went through this exact situation last year with a specialized treatment in Mexico. You need to do the following: 1. File your claim online through SDI Online (easiest way) 2. Download and print the DE 2501 form 3. Have your Mexican doctor complete Part B with their license info 4. Make sure ALL documentation is translated to English (this is critical) 5. You can upload the completed forms through your SDI Online account Most important: get detailed medical notes explaining WHY this procedure is medically necessary. EDD scrutinizes international claims more closely. My claim took 5 weeks to process because they kept requesting additional documentation from my doctor.

Wouldn't it be easier to just have the surgery in California? Then you don't have to deal with the foreign doctor paperwork hassle. Just saying...

Have you tried calling EDD directly to ask? Oh wait, don't bother - you'll be on hold FOREVER and probably get hung up on multiple times. I tried calling with a similar question last month and never got through after 8 attempts over 2 days. I ended up using a service called Claimyr (claimyr.com) that got me connected to an actual EDD rep in about 20 minutes. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd. Way better than waiting on hold for hours only to get disconnected. The rep I spoke with was able to explain exactly what forms I needed for my specific situation.

BTW another thing to consider is that CA has a 7-day waiting period for SDI benefits. So you don't get paid for the first week you're out. Keep that in mind when planning your trip and recovery time!!!!

One more important detail: make sure your claim is filed within 49 days of your disability beginning (your surgery date). If you file late, you may lose benefits. Also, when you have your Mexican doctor complete the form, double-check that they've filled in ALL fields, including: - Their complete address (international address is fine) - Their license number - ICD-10 diagnosis code - Dates of disability (beginning and estimated return to work) - Their signature and date Missing information is the number one reason these claims get delayed. And yes, as someone mentioned, remember the 7-day unpaid waiting period at the beginning of your claim.

my sister just got back from having surgery in mexico and EDD totally denied her claim said something about the procedure not being "medically necessary" even tho her doctor wrote a whole letter... now shes appealing but its been 2 months with no money... just be prepared it might not work out

I found that having my US doctor also submit a note helped my case with my international treatment. They basically confirmed the diagnosis and necessity of the procedure, which seemed to give EDD more confidence in approving my claim. Might be worth asking your regular doctor here to provide supporting documentation if possible!

Just wanted to add one more tip from my experience - when you're getting your documents translated to English, make sure to use a certified translator if possible. EDD sometimes questions unofficial translations. Also, keep copies of EVERYTHING - the original Spanish forms, the English translations, and any supporting letters. If they request additional documentation later (which they often do for international claims), you'll have everything ready to go. Good luck with your surgery!

One thing I haven't seen mentioned yet is that you should also check if your surgery requires pre-authorization from EDD before you travel. Some procedures, especially elective ones, may need approval beforehand. I learned this the hard way when my friend's claim was initially denied because EDD said she should have gotten pre-approval for her procedure in Costa Rica. She eventually won on appeal, but it added months to the process. You might want to call EDD (or use that Claimyr service someone mentioned) to ask if your specific type of surgery requires pre-authorization for international treatment. Better to find out now than after you've already had the surgery!