TN 1 (03-99)

A. Introduction

The following subsections show the types of evidence that may be used to support claims for Dutch benefits.

B. Policy - General

Under the agreement with the Netherlands, SSA will take applications for both regular and Totalization benefits on behalf of the Netherlands and provide limited assistance in obtaining evidence needed to support the claim.

C. Policy - Using U.S. evidence

Evidence which is used to establish a factor of entitlement for U.S. Social Security benefits may also be used by the Netherlands to establish the same factor for Dutch benefits. Consequently, it is unnecessary for the applicant to submit additional evidence to document a factor of entitlement for Dutch benefits when that factor has already been verified for SSA purposes.

D. Policy - Entitlement factors

The following indicates what factors of entitlement, in addition to insured status, must be established in claims for Dutch benefits.

1. Retirement

The entitlement factors which must be established for Dutch retirement claims are:

• age of worker

• marriage or living with another person, if a spouse's/partner's supplement claimed

2. Survivors

The entitlement factors which must be established for Dutch survivors claims are:

• death of worker

• age of surviving spouse and date of marriage, if widow(er) benefit claimed

• date of divorce, if divorced widow(er) benefit claimed

• age and relationship of child, if child's benefit or supplement claimed

3. Disability

The entitlement factors which must be established for Dutch disability claims are:

• age of worker

• degree of disability (medical evidence)

E. Procedure - General

Take the following actions when developing evidence to support claims for Dutch benefits.

1. Accepting Evidence

Accept any evidence the applicant wishes to submit. If the applicant does not want to release an original document, photocopy the evidence and certify the copy.

CAUTION: Do not hold claims for Dutch benefits for prolonged periods pending receipt of evidence. If an applicant is unable to obtain needed evidence within a reasonable time, transmit the claim to OIO without the evidence. Advise the applicant that the responsible Dutch agency will contact him/her directly to obtain any evidence it needs.

2. Types of Evidence

If the applicant requests guidance on the type of evidence to submit, see:

• Proof of age in GN 00302.000 ff.

• Proof of death in GN 00304.000 ff.

• Proof of marriage in GN 00305.000 ff.

• Proof of parent/child relationship in GN 00306.000 ff.

3. Document the File

Document the file to show when a factor of entitlement for a Dutch benefit has already been verified for a U.S. claim.

a. Concurrent Title II Claim

Send a photocopy of the relevant evidence with the Dutch claim to OIO if the concurrent title II claim will be sent to a PSC other than OIO.

b. Prior Title II Claim

Include an MBR printout in the claims file sent to OIO to show which factors, other than disability, have been verified in a prior file.

4. Obtain Record of NH's U.S. Coverage

Obtain a record of the NH's U.S. coverage in all claims for Dutch benefits. When the applicant is filing for both U.S. and Dutch benefits, completion of the MCS screens will automatically generate a separate earnings record for the Dutch claim.

When a claimant files for Dutch benefits only, which is a complex MCS exclusion, request an Informational/Certified Earnings Record (ICERS). For more information about requesting a U.S. earnings record, see GN 01702.215C.3.

F. Procedure - Retirement claims

In addition to taking the actions in GN 01725.210E., take the following actions when developing Dutch retirement claims.

1. Obtain Statement of Residence

If the claimant was born before 1942, indicate in the “Remarks” section of the paper Form SSA-2490-BK the claimant's place(s) of residence from age 59 on. If the claim is taken on MCS, enter this information on the TOTALIZATION REMARKS (FRMK) screen. The Dutch agency needs this information to determine whether to compute the Dutch benefit using noncontributory coverage credits (see GN 01725.125A.1.).

2. Obtain Statement About Partner

The amount of the Dutch retirement pension may be increased if the claimant shares a household with another person (partner). The claimant and the partner do not have to be married and can be the same sex. Indicate in the “Remarks” section of the paper Form SSA-2490-BK whether the claimant shares his/her household with another person. If the claim is taken on MCS, the FOREIGN RESIDENCE (FRES) screen contains a question asking for this information. The Dutch agency will use this information in determining the retirement pension amount.

G. Procedure - Disability claims

In addition to taking the actions in GN 01725.210E., take the following actions when developing medical evidence for Dutch disability claims.

1. Dutch Benefits Only

Accept any medical evidence the applicant wishes to submit. Do not attempt to secure evidence for the claimant or offer advice as to what types of evidence may be needed by the Netherlands.

• Send any medical evidence that is submitted along with the claims file to OIO.

• Transmit the file without medical evidence if it is not readily available. Advise the claimant that the Dutch agency will contact him/her directly, if necessary, to obtain additional evidence.

2. Dutch Benefits and Concurrent Title II Claim

Follow the instructions in GN 01702.200 - GN 01702.215 to process claims for Dutch disability benefits and concurrent title II disability claims.

H. References

• Procedure, GN 01702.215C

• Certifying evidence for Totalization claims, GN 00301.105

• Completing the SSA-2490 screens on MCS, MSOM MCS 007.001