Non Industrial Disability Insurance Form

Edd ndi po box 2168.

Non industrial disability insurance form. Ndi claimants are responsible for fling claims promptly and accurately. You can get medical extension forms by contacting the edd at 1 866 758 9768. Ask your employer s personnel specialist or payroll officer for the first claim for nonindustrial insurance ndi de 8501. Stockton ca 95201 2168.

Ndi claimants may be required to submit to an examination to determine physical or mental disability. Provides the employee with the enhanced non industrial disability insurance ndi annual leave election dgs ohr 101 form to indicate his her level of supplementation. Nonindustrial disability insurance. Contact the edd at 1 866 758 9768 to get medical extension forms.

For a list of eligibility requirements visit nonindustrial disability insurance. Fees for such examinations are paid by the state. Requirements and responsibilities. Nonindustrial disability insurance claim process.

If any item is not completed on the form it will be returned for completion and the benefit payment may be delayed for the employee. Refer to your employer s personnel specialist or payroll officer to obtain the ndi claim form de 8501. Non industrial disability insurance ndi covers excluded employees and rank and file employees in bargaining units 2 5 6 7 8 9 10 12 13 16 18 and 19. Non industrial disability insurance ndi is a program funded by state employers to provide partial wage replacement to eligible state employees who have wage loss due to a non work related illness or injury including disability due to pregnancy.

Po box 2168.