TN 7 (02-23)

GN 01733.210 Developing Evidence and Establishing Entitlement Factors in Claims for U.S. and Luxembourg Benefits

A. Filing applications

Under the agreement with Luxembourg, SSA accepts applications for both regular and Totalization benefits on behalf of Luxembourg. SSA also provides limited assistance in obtaining the required evidence to support the applicant's claim.

B. Using evidence submitted in the claim for U.S. benefits

Applicants do not need to submit additional evidence to file for Luxembourg benefits since evidence used to establish a factor of entitlement for U.S. Social Security benefits, both regular and Totalization, is sufficient for Luxembourg to establish the same factor for Luxembourg benefits.

C. Establishing entitlement factors and evidence requirements

In addition to insured status, evidence of the following are required in support of an application for Luxembourg benefits. When a person files for U.S. Totalization benefits under the agreement with Luxembourg, the applicant must submit the same evidence necessary to establish a claim for regular (non-totalization) retirement, survivors, or disability insurance benefits. In addition, applicants must submit the evidence noted in GN 01702.200 - GN 01702.230.

1. Required evidence when filing an application for retirement benefits

When a worker files an application for retirement benefits, obtain the following evidence:

  • Worker's date of birth; and

  • Worker's Luxembourg insurance number; and

  • Marital status, (if spouse's supplement is claimed); and

  • Family composition; and

  • Dates of birth of all family members; and

  • Age and relationship of child, disability status, and school attendance (if a child's supplement is claimed); and

  • Age, marriage and divorce, (if divorced spouse's benefit is claimed); and

  • Age and relationship of parent, (if parent's or spouse's parent's supplement is claimed); and

  • Disability status of all family members.

2. Required evidence when filing an application for survivors benefits

When a person files an application for survivors benefits, obtain the following evidence:

  • Worker's Luxembourg insurance number; and

  • Worker's date of birth and death; and

  • Date of marriage or partnership registration (if surviving spouse/divorced spouse or surviving registered/dissolved registered partner's benefit claim); and

  • Marriage and divorce or legal separation of partnership, (if a divorced surviving spouse's benefit is claimed); or

  • Age and disability status of child or grandchild, (if a child's benefits claimed).

  • Surviving spouse's age and disability status; and

  • Age or disability status of parents or grandparents (including spouse's parents or grandparents).

3. Developing evidence in support of an application for disability benefits

Entitlement factors for Luxembourg are based on the degree of the worker's disability.

Take the following actions when developing evidence to support applications for Luxembourg benefits:

  • Worker's date of birth; and

  • Worker's Luxembourg insurance number; and

  • Degree of disability (medical evidence required).

  • Marriage, (if spouse's supplement is claimed); and

  • Age, marriage and divorce, (if divorced spouse's benefit is claimed); and

  • Age and relationship of child, (if child's supplement is claimed); and

  • Age and relationship of parent, (if parent's or spouse's parent's supplement is claimed).

D. Developing medical evidence in support of an application for retirement, survivors, or disability benefits

Refer to the following policy if the applicant requests guidance on the types of evidence to submit:

1. Research the type of evidence

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

2. Accepting evidence

The applicant must submit the evidence noted in GN 01702.200 - GN 01702.230 whenever Totalization benefits are claimed from Luxembourg.

  • SSA accepts any medical evidence the applicant wishes to submit; and

  • If the applicant does not want to release an original document, photocopy the evidence and certify the copy (see GN 00301.105); and

  • Do not attempt to secure evidence for the applicant or offer advice as to what types of evidence Luxembourg may need.

Send all submitted medical evidence to the Office of International Operations (OEIO)/Division of International Operations (DIO) at the following addresses:

 

 

Note: If claim is mailed via USPS, mail to:

Social Security Administration

OEIO - DIO

P.O. Box 17769

Baltimore, MD 21235-7769

USA

FAX number: 410-966-1861

 

Note: If courier service is used, address to:

Social Security Administration

Division of International Operations

6100 Wabash Avenue

Baltimore, MD 21215
  • Complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the Luxembourg claim to OEIO. Show "Totalization" as the ISSUE; and

  • Inform the applicant that the responsible Luxembourg agency will contact them directly to obtain evidence needed to make a determination.

    CAUTION: Do not hold claims for Luxembourg 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 OEIO/DIO without the evidence. Advise the applicant that the responsible Luxembourg agency will contact them directly to obtain any needed evidence.

3. Document the File

Document the file as follows:

  • Indicate on the Luxembourg benefit claim file any factor of entitlement verified previously for a U.S. claim; and

  • For concurrent Title II claims, send the Title II claim and relevant evidence to the Program Service Center (PSC) of jurisdiction; and

  • Electronically send a certified photocopy of the relevant evidence with the Luxembourg claim to OEIO/DIO.

4. Obtain the Number Holder's (NH) U.S. earnings record

Obtain NH's U.S. earnings record for all claims for Luxembourg benefits as follows.

  • When the applicant is filing for both U.S. and Luxembourg benefits, complete the modernized claims system (MCS) screens; and

  • The MCS screens will automatically generates a separate earnings record for the Luxembourg claim; and

  • When an applicant files for Luxembourg benefits only, which is an MCS exclusion, request an Informational/Certified Earnings Record (ICERS) per MS ICER 02101.004; and

  • Obtain proof of lag earnings (unposted paid earnings in the current and preceding year) if the applicant alleges U.S. covered work in the lag period and is filing for any Luxembourg benefits; and

  • For proof of lag wages, see RS 01404.005 and RS 01404.018; and

  • For proof of lag self-employment income, see RS 01804.100D.

E. Developing medical evidence for Luxembourg disability claims

In addition to the actions in GN 01733.210D, take the following actions when developing medical evidence for Luxembourg disability claims:

1. Luxembourg benefits only

  • Accept any medical evidence the applicant wishes to submit when the application is for Luxembourg benefits only. Do not attempt to secure evidence for the applicant or offer advice as to what types of evidence Luxembourg need; and

  • Send all submitted medical evidence and the claims file to OEIO at the following address:

 

 

Note: If claim is mailed via USPS, mail to:

Social Security Administration

OEIO - DIO

P.O. Box 17769

Baltimore, MD 21235-7769

USA

FAX number: 410-966-1861

Note: If courier service is used, mail to:

Social Security Administration

Division of International Operations

6100 Wabash Avenue

Baltimore, MD 21215
  • Complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the Luxembourg claim to DIO. Show "Totalization" as the ISSUE.

  • Transmit the file without medical evidence if the evidence is not readily available. Advise the applicant that the Luxembourg agency will contact them directly to obtain any required evidence.

2. Luxembourg benefits and concurrent U.S. Title II claim

To process claims for Luxembourg disability benefits and concurrent Title II disability claims, follow the instructions in GN 01702.400 - GN 01702.415.

F. References

  • GN 00301.105, Certifying evidence for Totalization claims.

  • GN 00302.000, Proof of Age.

  • GN 00304.000, Proof of Death.

  • GN 00305.000, Proof of Marital Relationship.

  • GN 00306.000, Child Relationship and Dependency.

  • GN 01702.110, Application for Benefits under a U.S. International Social Security (Totalization) Agreement (Form SSA-2490-BK).

  • GN 01702.400, Developing Medical Evidence in Claims for U.S. Totalization Disability Benefits.

  • GN 01702.415, Development of Medical Evidence and Routing of Claims for Foreign Disability Benefits.

  • MS 02101.004, Informational/Certified Earnings Records - Totalization (ICIC).

  • MS 03507.001, Introduction to SSA-2490 - Overview.

  • MS 03509.011, Totalization (TOTL) screen.

  • RS 01301.000, Living With, Contributions and One-Half Support.

  • RS 01404.005, Lag earnings.

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201733210
GN 01733.210 - Developing Evidence and Establishing Entitlement Factors in Claims for U.S. and Luxembourg Benefits - 02/08/2023
Batch run: 02/08/2023
Rev:02/08/2023