TN 3 (02-95)

GN 01703.320 How to Use the Overprinted SSA-3428-U2 (Determination of Disallowance Coding Sheet)

A. When to use

The overprinted SSA-3428-U2 is used to document a totalization disallowance and to designate the disallowance letter and appropriate paragraphs. It is used to document disallowances for all claimants who are being denied. Auxiliaries listed on the totalization application are shown on the overprinted SSA-3428-U2.

This form is also completed when an auxiliary's claim is being denied but the worker's claim is being awarded; e.g., the worker, age 65, listed a young spouse on the application but there are no minor children.

B. Procedure

When preparing an overprinted SSA-3428-U2:

  • Complete all information in the areas that are not blocked out.

  • Designate the appropriate disallowance letter and appropriate totalization denial and reconsideration paragraphs.

  • Enter the most advantageous date claim filed for totalization benefits based on information in file to allow the BETs to certify the most advantageous date to foreign agencies.

  • Route the folder to a BA to post the TSC D2 when insured status is not met after combining coverage from both countries.

C. Exhibit

G-GN_01703.320C

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GN 01703.320 - How to Use the Overprinted SSA-3428-U2 (Determination of Disallowance Coding Sheet) - 06/02/2014
Batch run: 06/02/2014
Rev:06/02/2014