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GN 01713.215: Application for Benefits Under the Belgian Agreement

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  • Effective Dates: 04/24/2014 - Present
  • Effective Dates: 04/12/2018 - Present
  • TN 3 (01-03)
  • GN 01713.215 Application for Benefits Under the Belgian Agreement
  • A. Policy
  • An individual who wishes to file for benefits under the agreement with Belgium must complete Form SSA-2490-BK (Application For Benefits Under A U.S. International Social Security Agreement). This is true whether the applicant is filing for benefits only from the United States, only from Belgium or from both countries.
  • B. Process
  • 1. When the Modernized Claim System (MCS) Version May Be Used
  • The SSA-2490-BK is available through the modernized claims systems (MCS), but the MCS version may only be used when the number holder (NH) is filing for:
  • * U.S. retirement or disability Totalization benefits only, or
  • * U.S. retirement or disability benefits (regular or Totalization) and concurrently for Belgian benefits.
  • 2. When the MCS Version May Not Be Used
  • The MCS version of the SSA-2490-BK may not be used to file for:
  • * Belgian benefits only, or
  • * U.S. or Belgian survivors benefits.
  • A paper or electronic (e-form) SSA-2490-BK application form must be used in these cases. Form SSA-2490-BK is also available through the Totalization Benefits Resource Kit on the Intranet at http://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp
  • A paper or electronic (e-form) SSA-2490-BK application form must be used in these cases. Form SSA-2490-BK is also available through the Totalization Benefits Resource Kit on the Intranet here.
  • NOTE: It is not necessary to take an SSA-2490-BK in claims for U.S. auxiliary benefits in life cases or in survivor cases where there was a previously approved award in a life case since this application would have been completed previously in connection with the NH's claim.
  • C. Procedure — Required applications
  • Use the following information to determine which applications must be completed when taking claims for U.S. Totalization benefits and/or Belgian benefits under the agreement with Belgium.
  • 1. U.S. Totalization Benefits Only
  • a. Retirement or Disability Claims
  • In retirement or disability claims, complete the appropriate retirement or disability benefit MCS application screens, the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011 ), and the SSA-2490 screens (see MSOM MCS 007.001 ).
  • b. Survivors Claims
  • In survivors claims, complete the appropriate MCS application screens, the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011 ), and Part I of the paper or electronic (e-form) application Form SSA-2490-BK.
  • 2. Belgian Benefits Only (Regular or Totalization)
  • Claims for Belgian benefits only (regular or Totalization) are MCS exclusions. Complete Parts I and II of the paper or electronic (e-form) application Form SSA-2490-BK.
  • 3. Belgian Benefits (Regular or Totalization) and U.S. (Regular or Totalization) Benefits
  • a. Retirement or disability claims
  • In retirement or disability claims, complete the appropriate retirement or disability benefit MCS application screens, the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011 ), and the SSA-2490 screens (see MSOM MCS 007.001 ).
  • b. Survivors claims
  • In survivors claims, complete the appropriate MCS application screens, the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011 ), and Parts I and II of the paper or electronic (e-form) application Form SSA-2490-BK.
  • NOTE: Form SSA-2490-BK is available through the Totalization Benefits Resource Kit on the Intranet athttp://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp
  • NOTE: Form SSA-2490-BK is available through the Totalization Benefits Resource Kit on the Intranet here.
  • D. References
  • * Completing the SSA-2490 on MCS, MSOM MCS 007.001
  • * Completing the paper or electronic (e-form) Form SSA-2490-BK,
  • * Totalization requirements, MSOM MCS 009.011
  • * Forwarding foreign application to the Office of International Operations, GN 01702.325
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