If an applicant wishes to file for Slovak benefits and does not bring the special
Form for Slovak benefits (SK/USA 2) to the FO:
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•
Obtain a copy of Form SK/USA 2 from the Division of International Operations (DIO)
Totalization Forms
Intranet website; and
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•
Print Form SK/USA2 and instructions and give to the applicant to complete; and
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•
Provide assistance in completing the Form SK/USA 2; and
NOTE: Most applicants filing for Slovak benefits should be able to complete the application
without assistance by using the instructions provided with the application.
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•
Witness the applicant signature on the Form; and
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•
Accept, date and location stamp the application; and
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•
Photocopy and certify the photocopied application; and
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•
Request an “Informational/Certified Earnings Record” (ICERS) per MSOM ICERS 001.004;
and
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•
Photocopy and certify the photocopies of any documents (evidence) the Slovak agency
has requested that the applicant include with the Slovak claim; and
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•
Send the ICERS and the original SSA date and location-stamped Slovak application and
any additional SSA-certified claims material (photocopies of evidence) to the Division
of International Operations (DIO) at the following address:
Social Security Administration
Division
of International Operations
P.O. Box 17769
Baltimore, Maryland
21235-7769
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•
Complete the Modernized Development Worksheet (MDW) screen to show the date the FO
sent the claim for Slovak benefits to OEIO/DIO; and
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•
Show “Totalization” as the ISSUE when completing the MDW screen; and
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•
Return to the claimant the photocopy of the Form SK/USA 2 and any original evidentiary
documents submitted by the claimant.
Once OEIO/DIO receives the claim, OEIO/DIO will send the claim directly to the Slovak
agency along with the evidence and the worker’s U.S. coverage record.