notice to employees nonindustrial disability ins urance

NOTICE TO EMPLOYEES
NONINDUSTRIAL DISABILITY INS URANCE
• WHEN YOU ARE UNABLE TO WORK BECAUSE OF SICKNESS OR INJURY, YOU MAY BE ELIGIBLE TO RECEIVE
NON INDUSTRIAL DISABILITY INSURANCE
• NONINDUSTRIAL DISABILITY INSURANCE CLAIM FORMS, DE 8501, MAY BE OBTAINED FROM YOUR LOCAL OFFICE
ATTENDANCE CLERK, DEPARTMENT PERSONNEL OFFICE OR EDD DISABILITY INSURANCE FIELD OFFICE
• THE "FIRST CLA IM" MUST BE MAl LED NOT LATER THAN THE 20TH DAY AFTER THE FIRST DAY FOR W HICH
BENEFITS ARE PAY ABLE IF YOU ARE TO RECEIVE CREDIT FROM THE TIME YOU FIRST BECOME DISABLED·
• ALL VOLUNTARY DEDUCTIONS ARE WITHHELD UNLESS CANCELLED BY THE EMPLOYEE
• STATE AND FEDERAL TAXES ARE WITHHELD FROM THE BENEFITS
• FOR FURTHER INFORMATION CONTACT:
NDI
EMPLOYMENT DEVELOPMENT DEPARTMENT
NONINDUSTRIAL DISABILITY INSURANCE
P .0. BOX 13140
SACRAMENTO, CALIFORNIA 95813
EDD
LINKING PEOPLE WITH JOBS
PHONE: (916) 445 -0546
IT IS YOUR RESPONSIBILITY TO - FILE PROMPTLY. YOU MAY LOSE BENEFITS TO WHICH YOU W OULD
OTHERWISE BE ENTITLED IF YOU DELAY FILING OF YOUR CLAIM.
DE 8506 (8-78)