Basic (03-86)
International Program Service Center (INTPSC) has jurisdiction for initial claims
filed by or on behalf of individuals living outside of the 50 States, Virgin Islands,
American Samoa, District of Columbia, Puerto Rico and Guam, including claims filed
by individuals who use an APO or FPO address. INTPSC also has jurisdiction of determinations
of continuing disability when the disabled individual uses a foreign address.
Jurisdiction of a claim or CDR may be affected when the disabled individual moves
to or from a foreign country. Generally, a change of residence constitutes a move.
It may be a seasonal move, or a hospital stay, but the claimant should intend to reside
at this new address for at least 60 days. A hospital stay, visit to another country,
U.S. or other temporary absence from a residence for less than 60 continuous days,
would not constitute a move. (See DI 43505.005 and DI 43505.015 for detailed instructions when a claimant moves to or from a foreign country.)
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A.
INTPSC will receive by an SSA-831-U5 any disability claim (DIB, DWB, CDB, DMC) which
is filed by or on behalf of an individual physically residing outside the 50 States,
the District of Columbia, Virgin Islands, Guam, American Samoa, or Puerto Rico. “Disability claim” includes a request for a disability determination for Medicare filed by a mother
(including a surviving divorced mother) or widow(er) beneficiary age 50-64 who alleges
disability within the prescribed period. The prescribed period for Medicare purposes
is extended to age 65 rather than age 60 for DWB cases.
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B.
The DO will ultimately route to INTPSC any disability claim filed by or on behalf
of individuals in the U.S. under international Social Security agreements (totalization).
Disability claims filed under the totalization program will fall into one of three
categories; the category is determined by the insured status of the worker at the
time of filing. The three categories of disability claims are:
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1.
Those in which the worker is insured for SSA disability benefits based on U.S. earnings
alone;
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2.
Those in which the worker has at least 6 U.S. QC's and with foreign earnings is probably
insured for totalized benefits from SSA; and
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3.
Those in which the worker does not have at least 6 U.S. QC's or is probably not insured
even if U.S. and foreign periods of coverage are combined.
Where the worker is insured for SSA disability benefits on U.S. earnings alone, or
is filing for SSI benefits and meets the income and resources requirements, the DO
will send the disability claim to the DDS for development of medical evidence and
preparation of the disability determination. The DO will then forward the folder to
INTPSC for any necessary processing center action.
Where the worker has at least 6 U.S. QC's and is probably insured for totalization
benefits by combining U.S. and foreign earnings, the DO will forward the disability
claim to the DDS for medical development. Upon completion of the DDS medical development,
the DO will forward the claim to INTPSC for preparation of the disability determination
and any necessary processing center action.
The DO will route those claims in which the worker does not have at least 6 U.S. QC's
or is probably not insured even if U.S. and foreign periods of coverage are combined
directly to INTPSC. If INTPSC module personnel determine that the claimant is insured
for totalized benefits, the claim will be forwarded to a disability examiner in INTPSC
for medical development and a disability determination.
(See GN 01701.005 for a description of the totalization program and GN 01702.400 for specific DO routing instructions.)
NOTE: Totalization claims filed by or on behalf of individuals physically residing outside
the 50 States, the District of Columbia, Virgin Islands, Guam, American Samoa, or
Puerto Rico will be forwarded directly to INTPSC for medical development and the disability
determination.