TN 2 (03-04)

GN 01702.400 Developing Medical Evidence in Claims for U.S. Totalization Disability Benefits

A. Introduction

In order to avoid unnecessary development, field offices (FOs) should generally develop medical evidence in claims for U.S. Totalization disability benefits only when it appears the number holder (NH) can meet insured status requirements based on combined U.S. and foreign coverage.

B. Procedure

1. When to develop medical evidence

  • Develop medical evidence when the NH has at least 6 quarters of coverage (QCs) and it appears, based on subsection GN 01702.400B.2., the NH will be insured based on combined U.S. and foreign coverage.

  • Do not develop medical evidence if the NH has less than 6 QCs.

  • Do not develop medical evidence if the NH has at least 6 QCs but it appears, based on subsection GN 01702.400B.2., the NH will not be insured even when foreign coverage is considered. (If the NH is insured after the foreign coverage record is received, OIO will initiate development of medical evidence.)

2. Determining if the NH meets insured-status requirements

  • Convert the alleged foreign coverage to QCs following the rules in the subchapter dealing with the specific agreement.

  • Consider both the length of the alleged foreign coverage (for fully insured status) and the period of alleged coverage (if disability insured status is involved).

  • Assume insured-status requirements will be met based on combined U.S. and foreign coverage if there is any doubt.

C. Reference

Determining disability insured status, RS 00301.120


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GN 01702.400 - Developing Medical Evidence in Claims for U.S. Totalization Disability Benefits - 02/21/2014
Batch run: 02/21/2014
Rev:02/21/2014