TN 3 (02-95)
GN 01703.062 Processing Claims Leads When the Foreign Agency Submits a Liaison Form with a Check Block for U.S. Benefits That Is Completed
Several liaison forms contain check blocks that may be used to indicate the type of U.S. benefit for which the claimant wants to file. If one of these blocks is checked, DIO and FSPs use the following instructions to determine if there is a claims lead and if an informal denial notice is necessary.
Follow these steps for processing a liaison form with a completed check block:
1. Determination of eligibility
Determine if the claimant is eligible for U.S. benefits following the guidelines in GN 01703.061B.
2. Development of claim
Develop a U.S. claim or obtain a statement that the claimant does not wish to file if the claimant is eligible for benefits. Include QC information when forwarding a lead to an FSP. If the liaison form is received in the FSP, the FSP should take claims development action as described in GN 01703.061B forward the claim to IBO or the statement to the module.
3. Entitlement to U.S. benefits
Take no claims action if the claimant is already entitled to U.S. benefits.
NOTE: If the foreign agency has requested information, the FSP forwards the liaison form to DIO. If not, the FSP may destroy the liaison form.
4. Routing claim
Forward the case to a CA in the module for an informal denial if the claimant does not meet the eligibility requirements.
Send a denial notice, if the NH has less than six QCs, which contains a paragraph to advise the claimant that six QCs are required before we can combine coverage with another country.