GN 01716.240 Facts About the Quebec Liaison Form QUE/USA 2

A. List of form QUE/USA 2 functions

Quebec uses Form QUE/USA 2 to:

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transmit claims and related material to the four border FOs which service Quebec.
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send information requested by OIO or the border FOs to OIO.
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request information from OIO.

Most entries on the form are self explanatory with the exception of those specifically listed below:

CERTIFICATION OF DATA - A) FAMILY MEMBERS, B) EVENTS

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Quebec uses this section to certify data taken from their records pertaining to the worker and his family. Also contained in this section is the date a disability onset was established under QPP regulations.
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These dates will be used without further verification unless there is a material discrepancy with other evidence in file. (See GN 01701.210 regarding verification of eligibility factors by foreign agencies.)

INFORMATION PROVIDED BY D.A.E.S.S.

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Quebec checks the appropriate blocks to show information that they are providing with this liaison form.
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Periods of coverage - The periods of Canadian coverage are listed on the right hand side of this section when someone has filed for U.S. benefits.
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When coverage appears in this section for a year after the year of alleged disability onset, RRQ should be contacted to determine if the coverage is based on work.
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When a person has no coverage in Canada, Quebec enters a zero in the total block.
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The filing date of the current application is hand written in the space to the right of the heading, “Information Provided by D.A.E.S.S.”

REMARKS

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Quebec enters an earlier protective filing date in this section if the claimant had previously filed for QPP benefits and indicated U.S. coverage on that application.
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If the two filing dates would result in different months of entitlement, the date which provides the greatest advantage to the claimant should be used.

INFORMATION REQUIRED BY REGIE DES RENTES DU QUEBEC

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Quebec has provided a statement at the beginning of this section which indicates whether the information requested below is needed to process a claim under the agreement. If “YES” is checked, this eliminates the need for a copy of the individual's consent before we can release the information.
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If no is checked, be sure a consent statement is obtained before releasing the information.

Use the QUE/USA 2 to respond to RRQ requests for information instead of preparing a new SSA-2960-U3-CQ. To do this:

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Reverse the heading of the “TO”/“FROM” blocks at the top of the form,
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Staple the requested material to the QUE/USA 2,
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Place the material in an envelope addressed to the RRQ. Use a pre-printed label to address the envelope.