POMS Reference

This change was made on Dec 29, 2017. See latest version.
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GN 01753.220: Additional Applications for Benefits Under the Agreement with the Slovak Republic

changes
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  • Effective Dates: 07/28/2014 - Present
  • Effective Dates: 12/29/2017 - Present
  • BASIC (07-14)
  • GN 01753.220 Additional Applications for Benefits Under the Agreement with the Slovak Republic
  • A. Forms to complete for Slovak benefits
  • Along with the Form SSA-2490-BK (Application for Benefits under a U.S. International Agreement), an applicant for Slovak benefits must complete a special Slovak application form.
  • B. Application process for Slovak benefits
  • The special Slovak application is Form SK/USA 2 (Claim for Pension Benefits from the Pension Insurance System of the Slovak Republic).
  • The bilingual Slovak application form is available through the Slovak Republic Social Insurance Agency website.
  • C. Procedure for filing an application for Slovak benefits
  • 1. Applicant brings the special Form SK/USA 2 to file for Slovak benefits
  • If an applicant wishes to file for Slovak benefits and brings the special form (SK/USA 2) for Slovak benefits to the FO:
  • * accept, date and location stamp the application.
  • * photocopy and certify the photocopied application.
  • * photocopy and certify the photocopies of any additional documents (evidence) the Slovak agency requested that the applicant included with the Slovak claim.
  • * request an “Informational/Certified Earnings Record” (ICERS) per MSOM ICERS 001.004, and send the ICERS and the original SSA date and location-stamped Slovak application and any additional SSA-certified claims material (photocopies of evidence) to the Office of International Operations (OIO) in Baltimore at the following address:OIO – TotalizationP.O. Box 17769Baltimore, Maryland 21235-7769
  • * complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the Slovak claim to OIO.
  • * request an “Informational/Certified Earnings Record” (ICERS) per MSOM ICERS 001.004, and send the ICERS and the original SSA date and location-stamped Slovak application and any additional SSA-certified claims material (photocopies of evidence) to the Office of Earnings and International Operations (OEIO)/Division of International Operations (DIO) in Baltimore at the following address: OEIO/DIO P.O. Box 17769 Baltimore, Maryland 21235-7769
  • * complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the Slovak claim to OEIO/DIO.
  • * show “Totalization” as the ISSUE when completing the MDW screen.
  • * return to the claimant the photocopy of the SK/USA 2 and any original evidentiary documents submitted by the claimant
  • Once OIO receives the claim, they will send the claim directly to the Slovak agency along with the evidence and the worker’s U.S. coverage record.
  • Once OEIO/DIO receives the claim, they will send the claim directly to the Slovak agency along with the evidence and the worker’s U.S. coverage record.
  • 2. Applicant brings the special Form SK/USA 2 to file for Slovak benefits
  • If an applicant wishes to file for Slovak benefits and does not bring the special form for Slovak benefits (SK/USA 2) to the FO:
  • * obtain a copy of Form SK/USA 2 from the Social Insurance Agency website.
  • * print Form SK/USA2 and instructions and give to the applicant to complete;
  • * provide assistance in completing the Form SK/USA 2;
  • NOTE: Most applicants filing for Slovak benefits should be able to complete the application without assistance by using the instructions provided with the application.
  • * witness the applicant signature on the form.
  • * accept, date and location stamp the application.
  • * photocopy and certify the photocopied application.
  • * request an “Informational/Certified Earnings Record” (ICERS) per MSOM ICERS 001.004.
  • * photocopy and certify the photocopies of any documents (evidence) the Slovak agency has requested that the applicant include with the Slovak claim.
  • * send the ICERS and the original SSA date and location-stamped Slovak application and any additional SSA-certified claims material (photocopies of evidence) to the Office of International Operations (OIO) in Baltimore at the following address:Social Security AdministrationOIO – TotalizationP.O. Box 17769Baltimore, Maryland 21235-7769
  • * complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the claim for Slovak benefits to OIO
  • * send the ICERS and the original SSA date and location-stamped Slovak application and any additional SSA-certified claims material (photocopies of evidence) to the Office of Earnings and International Operations (OEIO)/Division of International Operations (DIO) in Baltimore at the following address: Social Security Administration OEIO/DIO P.O. Box 17769 Baltimore, Maryland 21235-7769
  • * complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the claim for Slovak benefits to OEIO/DIO.
  • * show “Totalization” as the ISSUE when completing the MDW screen.
  • * return to the claimant the photocopy of the Form SK/USA 2 and any original evidentiary documents submitted by the claimant.
  • Once OIO receives the claim, OIO will send the claim directly to the Slovak agency along with the evidence and the worker’s U.S. coverage record.
  • Once OEIO/DIO receives the claim, OEIO/DIO will send the claim directly to the Slovak agency along with the evidence and the worker’s U.S. coverage record.
  • D. References
  • * GN 00301.105 Certification of Evidence for Totalization Claims
  • * GN 01753.225 Requests for Status of Applications for Slovak Benefits