TN 3 (04-04)

A. Introduction

All applicants for Spanish benefits must complete a special application form E/USA (Claim for Benefits Under the Spanish Legislation). This form is in a bilingual Spanish-English format and is available through the Totalization Benefits Resource Kit on the Intranet at http://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp .

B. Procedure – Required application for Spanish benefits

The special Spanish application form is taken in the field offices (FO'). If an applicant wishes to file for Spanish benefits, the FO should:

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

2. Print the Spanish application form (E/USA) and give it to the applicant for completion.

3. Provide any necessary assistance in completing the Spanish form.
   NOTE: Most individuals filing for Spanish benefits should be able to complete the Spanish application form without assistance using the instructions provided with the application.

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

5. Send the Spanish E/USA form and the certified copies of evidence to the Office of Earnings and International Operations (OEIO)/Division of International Operations (DIO) in Baltimore at the following address:

   • Social Security Administration

   • OEIO/DIO

   • P.O. Box 17769

   • Baltimore, Maryland 21235-7769

6. Complete the Modernized Development Worksheet (MDW) screen to show the date the claim was forwarded to OEIO/DIO. Show “Totalization” as the ISSUE when completing the MDW screen.

Once OEIO/DIO receives the claim, OEIO/DIO will send the claim directly to the Spanish agency along with a copy of the applicant's U.S. coverage record.

C. Procedure – Status requests

When OEIO/DIO forwards the completed Spanish application form, certified copies of evidence and a copy of the applicant’s U.S. coverage record, OEIO/DIO annotates the MDW screen to show the type of claim, the date the claim was forwarded and that a notice was sent to the applicant.

Take the following steps if the applicant contacts the FO for the status of his or her claim for Spanish benefits:

1. Check the MDW screen to see if OEIO/DIO has sent the claim to Spain.

2. If OEIO/DIO hasn’t completed the MDW screen, advise the applicant to write directly to OEIO/DIO at the address shown in GN 01721.220B.

3. If OEIO/DIO has completed the MDW screen, advise the applicant to write directly to the Spanish agency shown on the notice he or she received from OEIO/DIO when the claim was forwarded.

D. Reference

Forwarding applications for foreign benefits to the OEIO/DIO, GN 01702.320