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GN 01743.210: Developing Evidence in Claims for Australian Benefits

changes
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  • Effective Dates: 05/01/2014 - Present
  • Effective Dates: 04/09/2018 - Present
  • BASIC (09-02)
  • GN 01743.210 Developing Evidence in Claims for Australian Benefits
  • A. Introduction
  • The following subsections show the types of evidence that may be used to support claims for Australian benefits.
  • B. Policy — General
  • Under the agreement with Australia, SSA will take applications for both regular and Totalization benefits on behalf of Australia and provide limited assistance in obtaining evidence needed to support the claim.
  • C. Policy — Using evidence submitted in claim for U.S. benefits
  • Evidence that is used to establish a factor of entitlement for U.S. Social Security benefits may also be used by Australia to establish the same factor for Australian benefits. Consequently, it is unnecessary for the applicant to submit additional evidence to document a factor of entitlement for Australian 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 residence requirements, must be established in claims for Australian benefits.
  • 1. All Claims
  • The entitlement factors that must be established for all Australian claims are:
  • * Income and assets of applicant
  • * Identity of applicant
  • 2. Retirement
  • The additional entitlement factors that must be established for Australian retirement claims are:
  • * Date of birth of applicant
  • * Date of birth of child(ren) under age 16 and relationship, if a supplement or parenting payment is claimed
  • 3. Survivors
  • The additional entitlement factors that must be established for Australian survivors claims are:
  • * Date of death of individual
  • * Date of birth of child(ren) under age 16 and relationship, if a parenting payment is claimed
  • * Date of marriage, if a bereavement payment/allowance is claimed
  • 4. Disability
  • The additional entitlement factors that must be established for Australian disability claims are:
  • * Degree of disability
  • * Date of birth of child(ren) under age 16 and relationship, if a supplement is claimed
  • E. Procedure — General
  • Take the following actions when developing evidence to support claims for Australian 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 Australian 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 the Office of International Operations (OIO) without the evidence. Advise the applicant that the responsible Australian 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 parent/child relationship in GN 00306.000 ff.
  • * Proof of identity in section A of the special application for Australian benefits (see GN 01743.220).
  • 3. Document the File
  • Document the file to show when a factor of entitlement for an Australian benefit has already been verified for a U.S. claim.
  • a. Concurrent Title II/Australian Claim
  • Send a certified photocopy of the relevant evidence with the Australian claim to OIO if the concurrent Title II claim will be sent to a program service center (PSC) other than OIO.
  • b. Prior Title II Claim
  • Include a master beneficiary record (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 the Number Holder's (NH's) U.S. Coverage
  • * Obtain a record of the NH's U.S. coverage in all claims for Australian benefits. When the applicant is filing for both U.S. and Australian benefits, completion of the modernized claims system (MCS) screens will automatically generate a separate earnings record for the Australian claim. When a claimant files for Australian benefits only, which is a complex MCS exclusion, request an Informational/Certified earnings record (ICER) per MSOM ICERS 001.004.
  • * Obtain proof of lag earnings if U.S. covered work in the lag period is alleged and the applicant is filing for any Australian benefit.
  • F. Procedure — Disability claims
  • In addition to taking the actions in GN 01743.210E., take the following actions when developing medical evidence for Australian disability claims.
  • 1. Australian Benefits Only
  • * Accept any medical evidence the applicant wishes to submit when the claim is for Australian benefits only. Do not attempt to secure evidence for the applicant or offer advice as to what types of evidence are needed by Australia. NOTE: Applicants for Australian disability benefits must also complete a Work Ability form (WA) which is available on the intranet at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm (see GN 01743.220).
  • * Accept any medical evidence the applicant wishes to submit when the claim is for Australian benefits only. Do not attempt to secure evidence for the applicant or offer advice as to what types of evidence are needed by Australia. NOTE: Applicants for Australian disability benefits must also complete a Work Ability form (WA) which is available on the intranet here. (see GN 01743.220).
  • * Send any medical evidence that is submitted along with the claims file to OIO at the address in GN 01702.310.
  • * Transmit the file without medical evidence if it is not readily available and advise the applicant that the Australian agency will contact him or her directly, if necessary, to obtain needed evidence.
  • 2. Australian Benefits and Concurrent Title II Claim
  • Follow the instructions in GN 01702.400 - GN 01702.415 to process claims for Australian disability benefits and concurrent title II disability claims. Also, have the applicant complete a Work Ability form which is available on the intranet at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm (see GN 01743.220).
  • Follow the instructions in GN 01702.400 - GN 01702.415 to process claims for Australian disability benefits and concurrent title II disability claims. Also, have the applicant complete a Work Ability form which is available on the intranet here. (see GN 01743.220).
  • G. References
  • Requesting an Informational/Certified Earnings Record, MSOM ICERS 001.004
  • Certifying evidence for Totalization claims, GN 00301.105
  • Lag earnings, RS 01404.005
  • Completing the SSA-2490 on MCS, MSOM MCS 007.001
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