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Submit Disability Income Assistance (DIA) Application documents online

Fill in the required information, then upload and submit at least 1 document related to a DIA Application.

Applicant information

First name (Required)

Last name (Required)

Date of birth (Required)
You must be 17.5 years or older to apply for Disability Income Assistance.

Personal Health Care Number (PHN)
Enter numbers only with no dashes or spaces.

City or town where applicant lives (Required)

Contact information

I am submitting 1 or more DIA Application documents for someone else.

Your first name (Required)

Your last name (Required)

Phone number
Including a phone number gives the DIA Application Processing Unit a way to contact you if we have questions about the documents you are submitting. If you choose to include it, enter numbers only with no dashes or spaces.

Email (Required)

Confirm email (Required)

Upload documents

You can upload documents in these file formats: PDF, JPEG, GIF, PNG, BMP or TIFF.
Each file can be up to 5 MB.
All files submitted at the same time can total 50 MB.
Make sure files are not password protected.

Disability Income Assistance Applicant Information

I am uploading the form and any extra pages added to give more space for information.

Select files
More rows will be added as needed.

Disability Income Assistance Medical Report

I am uploading the DIA Medical Report form and any extra pages added to give more space for information.

Select files
More rows will be added as needed.

Supporting documents

I am uploading documents showing personal, financial or medical information to support my application.

Select files
More rows will be added as needed.

Privacy: You are about to submit documents for your DIA Application. The personal information collected is authorized by sections 4(a) and 4(c) of the Protection of Privacy Act and section 5 of the Assured Income for the Severely Handicapped Act. This information will ensure your documents are linked to your DIA Application. For questions about the collection of personal information, contact Alberta Supports Contact Centre toll-free at 1-877-644-9992, from 7:30 a.m. to 8:00 p.m. every Monday to Friday, except statutory holidays.

Once the documents have been submitted, you will receive an email confirming they have been received.