An applicant filing for benefits under the U.S. - Korean Agreement must complete Form SSA-2490-BK (Application For Benefits Under a U.S. International Social Security Agreement), and any appropriate retirement, survivors or disability insurance application(s), and the special Korean application form. The Korean application form, along with instructions on how to complete the application, is available through the Totalization Benefits Resource Kit.

It is necessary to complete the Form SSA-2490-BK if the applicant is filing for any benefits under the Agreement: this could include benefits only from the United States, benefits only from Korea, or benefits from both countries.

An applicant who is filing for Korean benefits only, and NOT for benefits under the Agreement must complete the Korean application, but does not need to complete Form SSA-2490-BK.

In addition to Form SSA-2490-BK, an applicant for Korean benefits under the U.S. - Korean Agreement must complete one or more special Korean application forms. SSA Field Offices (FO) do not accept special Korean application forms.

After receiving a claim for Korean benefits filed with SSA, the Korean agency will:

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  Mail the appropriate Korean application forms to the applicant; and

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  Include instructions for the applicant to complete the Korean application forms, so the applicant can mail the forms directly to the Korean agency (along with any additional required evidence).

Form SSA-2490-BK (Application for Benefits under a U.S. International Social Security Agreement) is available through MCS. The MCS version of Form SSA-2490-BK is an option for filing only when the number holder (NH) is filing for:

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  U.S. retirement or disability Totalization benefits only; or

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  U.S. retirement or disability benefits (regular or Totalization) and concurrently for Korean benefits.

Do not use the MCS version of Form SSA-2490-BK when the applicant is filing for:

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  Korean benefits only; or

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  U.S. or Korean survivors benefits.

  Use the paper or electronic Form SSA-2490-BK for Totalization survivor claims. For instructions on how to complete the Form SSA-2490-BK, see GN 01702.110.

  NOTE: It is not necessary to take a Form 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 the NH previously completed one in connection with the previous application for benefits. The MCS version of the Form SSA-2490-BK may not be used to file for U.S. Totalization survivors benefits. A paper or electronic (e-form) Form SSA-2490-BK must be used in this case.

Use the following information to determine the application screens to complete when taking claims under the Agreement with Korean for U.S. Totalization or Korean benefits.

Along with the Form SSA-2490-BK, an applicant for Korean benefits under the U.S. - Korean Agreement must complete one or more special Korean application forms.

FOs do not accept special Korean application forms.

The Korean application form, along with instructions on how to complete the application, is available through the Totalization Benefits Resource Kit.

If an applicant brings Korean special application form(s) (or Form SSA-2490-BK) to the FO, the FO should:

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  Accept, photocopy, and certify the photocopied application; and

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  Photocopy and certify any additional documents (evidence) the Korean agency requested the applicant to include with the Korean claim; and

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  Request an "Informational/Certified Earnings Record" (ICERS) as described in MS 02101.004; and

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  Return to the applicant any original evidence documents and the certified photocopy of the application; and

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  Send the original Korean application and any certified photocopies or additional claims material to the Division of International Operations (DIO) in Baltimore at the following address:

NOTE: If courier service is used, mail to:

Once DIO receives the claim, they will send the claim directly to the Korean agency along with the evidence and the worker's U.S. earnings record. DIO will annotate the MDW to show the type of claim and the date they forwarded the claim to the Korean agency.

When DIO receives the Form SSA-2490-BK, they will send a notice to the applicant explaining this requirement to file another application and referring the applicant to the nearest Korean consulate or the Korean Embassy if necessary. If the applicant is a non-Korean citizen, advise the applicant that DIO will mail another application form to the applicant to complete and return to DIO.