TN 3 (02-95)
GN 01703.061 Processing Claims Leads From Spain When a Signed Statement of Intent to File for Benefits is Received
When claimants file with a Spanish agency and indicate that they wish to file for U.S. benefits, the Spanish agencies send Form USA/E 2 to the FSP. The Form USA/E 2 is signed by the claimant and indicates intent to file for all benefits for which the claimant is eligible. DIO and FSPs use the following instructions to develop a claim or close out the intent to file.
B. Procedure - FSP
FSP - Follow these steps for processing Form USA/E2.
1. Determination of eligibility
Determine if the claimant is eligible for U.S. benefits. Consider the claimant eligible if he/she is not already entitled to benefits, and
has at least six quarters of coverage (QCs) and is within 3 months of age 62 or older, or
has at least six QCs and there is an indication that the claimant is disabled, or
meets the requirements for entitlement as a survivor of a deceased NH who has at least six QCs.
Note: FSP - In making a decision about eligibility, follow procedures routinely used for developing claims inquiries. To avoid unnecessary development, the FSP may telephone IBO to request quarters of coverage information.
2. Development of claim
Develop a U.S. claim or obtain a statement that the claimant does not wish to file for benefits if the claimant is eligible for benefits. Forward claims material to IBO and statements that claimant does not wish to file to the totalization modules.
3. Routing claim
Route Form USA/E 2 to the totalization modules for the CA to promptly dispose of the claims lead if the claimant is not eligible for U.S. benefits. Annotate the form “not eligible.”
C. Procedure - DIO
Claims Specialist DIO - Use this procedure to process claims material from the FSP.
1. Eligible and a claim has been filed
If the claimant is eligible and a claim has been filed, process the claim to completion.
2. Eligible and no claim has been filed
If the claimant is eligible and no claim has been filed, retain the statement that has been submitted by the claimant stating that he/she does not wish to file a claim in the totalization modules for six months.
3. Already entitled to U.S. benefits
If the claimant is already entitled to U.S. benefits, send a notice to advise the claimant that no additional benefits are payable by the U.S.
4. Not eligible but NH has at least 6 QCs
If the claimant is not eligible but the NH has at least 6 QCs, send an informal denial notice with the reason for denial.
5. Not eligible and the NH does not have 6 QCs
If the claimant is not eligible and the NH does not have 6 QCs, send an informal denial notice. Advise the claimant that at least six U.S. QCs are needed before we can combine these quarters with credits from another country.