If an applicant wishes to file for Brazilian benefits and brings the special forms
for Brazilian benefits to the FO, take the following actions:
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•
accept, photocopy, and certify the application and the special forms;
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•
photocopy and certify any additional documents (evidence) the Brazilian agency requested
that the applicant include with the Brazilian claim;
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•
return the photocopied application and photocopied special forms to the applicant
with any original evidence documents;
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•
request an “Informational/Certified Earnings Record” (ICERS) as described in MS ICERS
001.004;
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•
send the original Brazilian application and special forms, with any additional claims
material such as certified photocopies of evidence documents to DIO at the following
address:
Office of Earnings and International Operations
Division of International
Operations
P.O. Box 17769
Baltimore, MD 21235
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•
Complete the MDW screen showing the date you sent the Brazilian claim to DIO. Show
“Totalization” as the ISSUE.
Once DIO receives the claim, they send it to the Brazilian agency with the evidence
and the worker’s U.S. coverage record. DIO annotates the MDW with the type of claim
and date and sends the claim to Brazil.
If an applicant wishes to file for Brazilian benefits and does not bring the Brazilian
special forms, see GN 01757.215 for instructions on how to accept the claim for benefits.