BASIC (09-05)

A. Policy

1. U.S. Totalization Benefits Only

An individual who wishes to file for U.S. Totalization benefits under the agreement with Japan must complete the appropriate modernized claim system (MCS) application screens as well a special Japanese application form (J/USA 4 – Claim for Verifying Period of Coverage). The J/USA 4 is in a bilingual Japanese-English format and is available through the Totalization Benefits Resource Kit on the Intranet http://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp . (A signature block is on the J/USA 4 because a signature is required in order for Japan to release information about the Japanese coverage record.)

NOTE: Form SSA-2490-BK (Application For Benefits Under a U.S. International Social Security Agreement) is not used to claim a U.S. Totalization benefit. The J/USA 4 should be used in lieu of the SSA-2490-BK.

2. U.S. Totalization and Japanese Benefits

An individual who wishes to apply for both U.S. Totalization and Japanese benefits must complete the appropriate MCS screens, the J/USA 4 application form and the appropriate Japanese application form (J/USA 1 or J/USA 2) discussed in GN 01745.220. (Field offices shouldn’t accept claims for Japanese benefits until 1 month prior to entitlement.)

3. Japanese Benefits Only

An individual who wishes to file only for Japanese benefits must complete the appropriate Japanese application form (J/USA 1 or J/USA 2) discussed in GN 01745.220 but does not need to complete the J/USA 4 application form or Form SSA-2490-BK. (Field offices shouldn’t accept claims for Japanese benefits until 1 month prior to entitlement.)

NOTE: When an applicant is filing for regular (nontotalization) benefits from the United States and benefits from Japan (regular or Totalization), it is not necessary to complete the SSA-2490. However, MCS will not allow clearance of the claim for U.S. benefits until the path for the SSA-2490 is entered. To clear the U.S. claim, complete only the first (FINF) screen in the SSA-2490 path. This will release the claim for U.S. benefits for award or denial. The claim for Japanese benefits should then be completed using the appropriate Japanese application form (J/USA 1 or J/USA 2) described in GN 01745.220.

B. Procedure – Required Applications for U.S. Totalization Benefits

Take the following steps when taking claims for U.S. Totalization benefits under the agreement with Japan:

1. Complete the appropriate MCS application screens for retirement, disability or survivors’ benefits.

2. Complete the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011).

3. Access the Totalization Benefits Resource Kit on the Intranet at http://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp .

4. Print form J/USA 4 and give it to the applicant to complete.

5. Provide any necessary assistance in completing the Japanese form.

   NOTE: Most individuals filing for Japanese benefits should be able to complete the Japanese form without assistance.

6. Photocopy and certify any documents (evidence) submitted by the applicant.

7. Process an initial insured-status denial (see GN 01702.315).

8. Forward the completed U.S. Totalization claim (with certified copies of evidence) to the Office of International Operations (OIO) in Baltimore at the following address:

   • Social Security Administration
     OIO - Totalization
     P.O. Box 17049
     Baltimore, Maryland 21235-7049

9. Complete the Modernized Development Worksheet (MDW) screen to show the date the claim is forwarded to OIO. Show “Totalization” as the ISSUE when completing the MDW screen.

C. References

• GN 01745.220, Completing the application form for Japanese benefits

• MSOM MCS 009.011, Totalization (TOTL)

• GN 01702.310, Forwarding applications to the Office of International Operations

• GN 01702.315, Processing notices in claims for U.S. Totalization benefits