TN 1 (03-97)
The FSP in Brussels, Belgium takes claims from individuals who wish to file for benefits under the agreement and also assists in processing claims filed with the Belgian social security agency.
When taking applications under the agreement, the FSP should follow the same general procedures and obtain the same applications and evidence as SSA field offices. (See GN 01702.001 - GN 01702.525 for FO and FSP development and GN 01713.205 for special evidence and application requirements for the agreement with Belgium.)
Follow the procedure below which describes development and routing instructions that apply to claims filed in the FSP.
If this is a U.S. claim, do the following:
Obtain Form SSA-2490-F4, Application for Benefits Under a U.S. International Social Security Agreement (Part I), and the appropriate RSDI applications.
Forward a liaison Form SSA-2960-U2-BE to the appropriate Belgian agency to request a Belgian earnings record, if it appears that the worker is not insured based only on U.S. coverage. For the Belgian self-employment agency, attach a statement signed by the applicant that he/ she does not wish to file for Belgian benefits. For the Belgian retirement and disability agencies, enter a statement in the “Remarks” block of the liaison form that the claim is for U.S. benefits only. NOTE: If the claim is for disability benefits and the claimant last worked or was registered as unemployed in Belgium, forward a liaison form SSA-2960-U2-BE to the Belgian disability agency in all cases to inform the agency that a U.S. claim has been filed. Obtain the claimant's consent to release this information to the Belgian agency if you are not simultaneously requesting a Belgian earnings record.
Forward the U.S. claim to the International Benefits Office (IBO) in DIO along with the file copy of the liaison form if it was sent to the Belgian agency.
If this is a Belgian claim, do the following:
Refer claimants who wish to file for Belgian retirement or survivors benefits to the appropriate Belgian agency to file a claim.
If the claimant wants to file for Belgian disability benefits, forward a liaison Form SSA-2960-U2-BE to the Belgian disability agency to identify the individual and certify the filing date.
If this is a concurrent U.S./Belgian claim, do the following:
Obtain Form SSA-2490-F4 (Parts I and II) and the appropriate RSDI applications.
Forward a liaison Form SSA-2960-U2-BE to the appropriate Belgian agency office to request a Belgian coverage record (if it appears that the worker is not insured based only on U.S. coverage) and to inform the Belgian agency of the filing date. For the Belgian self-employment agency, attach a statement signed by the applicant that he/she wishes to file for Belgian benefits.
Forward the claim to IBO in DIO along with the file copy of the liaison form sent to the Belgian agency.
Refer claimants for Belgian retirement or survivors benefits to the appropriate Belgian agency office to complete the required Belgian application form.