TN 1 (01-03)

A. Policy

An individual who wishes to file for benefits under the agreement with Ireland 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 Ireland or from both countries.

Note: Applications for Irish benefits may be filed up to 6 months in advance of the entitlement date.

B. PROCESS

1. When the Modernized Claims System (MCS) Version May Be Used

The SSA-2490-BK is available through 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 Irish 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:

• Irish benefits only, or

• U.S. or Irish 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 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 Irish benefits under the agreement with Ireland.

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. Irish Benefits Only (Regular or Totalization)

Claims for Irish 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. Irish 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 here.

D. Procedure – Entering Irish insurance number(s)

Enter the worker's “Social Insurance Number” (issued for work before 1979) or “Revenue and Social Insurance Number” (issued for work after 1978) on Form SSA-2490. Enter both Irish insurance numbers if the worker contributed to the Irish system both before 1979 and after 1978.

NOTE: Ireland changed its original social insurance numbering system in 1979. People who worked under the Irish system before 1979 have a Social Insurance Number consisting of 4 numeric digits. People who worked after 1978 have a Revenue and Social Insurance Number consisting of 8 or 9 digits (7 numbers followed by 1 or 2 letters). As a result, a worker may have two Irish insurance numbers.

E. Procedure – Irish insurance number(s) unknown

If the Irish insurance number(s) is unknown, indicate in the “Remarks” section of the paper or electronic Form SSA-2490-BK all of the worker's prior home addresses in Ireland. If the claim is taken on MCS, the FOREIGN RESIDENCE (FRES) screen should be completed showing all of the worker's prior home addresses in Ireland. The Irish agency needs this information to complete the NH's Irish coverage record.

F. Procedure – Irish survivors claims

If the applicant is claiming widow(er) or divorced widow(er) benefits from Ireland, enter the widow(er)'s or divorced widow(er)'s Irish insurance number(s) in the “Remarks” section of the paper or electronic Form SSA-2490-BK. Since the coverage requirements for Irish widow(er) or divorced widow(er) benefits can be met using either the NH's or the widow(er)'s or divorced widow(er)'s coverage record (see GN 01735.020B.4.a), Ireland needs the widow(er)'s or divorced widow(er)'s number(s) as well as the worker's.

G. References

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

• Completing the paper or electronic (e-form) Form SSA-2490-BK, GN 01701.350

• Totalization requirements, MSOM MCS 009.011

• Forwarding foreign application to the Office of International Operations, GN 01702.310