All applicants for Australian benefits must complete a special application form (Form
AUS140–US(A).0210). This form has two parts. Part A contains instructions for completing
the form and Part B is the actual application. Since Australian benefits are income/resource
tested, all applicants must also complete Form Mod (i) listing their income and assets.
In addition, applicants for Australian disability benefits must also complete a Work
Ability-Customer Information form (Form WA) showing how their disabilities impact
their daily activities.
When applicants submit special application forms for Australian benefit, the FO should:
-
1.
Access the Totalization Benefits Resource
Kit.
-
2.
Print Part A and B of the Australian application form (Form AUS140–US(A).0210) and
income and assets form (Form Mod i) and give them to the applicant for completion.
-
3.
If the applicant is filing for disability benefits, also print the Work Ability form
(Form WA) and give it to the applicant for completion.
-
4.
Provide any necessary assistance in completing the Australian forms.
-
5.
Photocopy and certify any documents (evidence) submitted by the applicant.
-
6.
Send the claim (with certified copies) to OIO in Baltimore at the address shown in
GN 01702.310.
Once OIO receives the claim, OIO will send the claim directly to the Australian agency
along with a copy of the applicant's U.S. coverage record.