Basic (04-19)

GN 01763.220 Additional Applications for Benefits under the Agreement with Iceland

A. Forms to complete for Icelandic Benefits

An applicant for Icelandic benefits must complete one or more special Icelandic application forms, in addition to Form SSA-2490-BK (Application for Benefits under a U.S. International Agreement). The form(s) will vary depending on the type of benefit.

B. Application process for Icelandic benefits

The Social Security Administration (SSA) field offices (FO) will not provide the applicant with the special Icelandic Application Form. After receiving a claim for Icelandic benefits filed with SSA, the Icelandic agency will contact the applicant directly, if necessary, to provide instructions for the applicant to complete and mail any other form(s) directly to the Icelandic agency along with any additional required evidence.

C. Procedure for filing an application for Icelandic benefits

If an applicant wishes to file for Icelandic benefits and brings the special forms for Icelandic benefits to the FO, take the following actions:

  • accept, photocopy, and certify the application.

  • photocopy and certify any additional documents (evidence) the Icelandic agency requested that the applicant included with the Icelandic claim.

  • request an “Informational/Certified Earnings Record” (ICERS) as described in MS ICERS 001.004.

  • send the Icelandic application and any additional claims material to the Division of International Operations (DIO) in Baltimore at the following address:

Office of Earnings and International Operations
Division of International Operations
P.O. Box 17769
Baltimore, MD 21235-7769
  • complete the Modernized Development Worksheet (MDW) screen to show the date the FO sent the Icelandic claim to DIO. Show “Totalization” as the ISSUE.

Once DIO receives the claim, they will send the claim directly to the Icelandic agency along with the evidence and the worker’s U.S. coverage record. DIO will annotate the MDW to show the type of claim and the date they forwarded the claim to the Icelandic agency.

If an applicant wishes to file for Icelandic benefits and does not bring the Icelandic special forms, for instructions on how to accept the claim for benefits, see GN 01763.215.

D. References

  • MS ICERS 001.004 Informational/Certified Earnings Records – Totalization (ICIC)

  • GN 01763.215 Applications for Benefits under the Agreement with Iceland

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201763220
GN 01763.220 - Additional Applications for Benefits under the Agreement with Iceland - 04/25/2019
Batch run: 04/25/2019
Rev:04/25/2019