TN 3 (02-95)
GN 01702.310 and GN 01702.320 provides routing instructions for claims for U.S. totalization benefits filed by
persons who are either insured based on U.S. coverage only or who have less than 6
U.S. QCs. These claims are rightfully the jurisdiction of a PSC, ODO, or modules 1
- 5 and not the totalization modules. The following procedure covers situations in
which these types of claims are routed to the totalization modules in error.
Claims Authorizer - Always take the following steps:
If there is a pending foreign agency assistance request with the U.S. claim or a claim
for foreign benefits, retain that request/claim and any related material in a totalization
Route the totalization folder to the LC to obtain the information requested by the
foreign agency or prepare a claims package. (Return the totalization folder to files
if the LC has already taken all necessary actions.)
If there is no pending foreign agency assistance request or claim for foreign benefits,
instruct the RAC to delete the "TF" case control record and destroy the totalization
Place the totalization application and any material related to that claim received
from the foreign agency on the right side of the RSI folder.
Complete, sign, and reverse file a folder documentation notice (see Exhibit GN 01703.270.E) on the right side of the RSI or DIB folder.
CA -Handle a misrouted claim for U.S. benefits as follows:
If the rerouted claim is a retirement or survivor claim, and the worker is insured based only on U.S. coverage only, and
it is detected in screening - route the claim to module 1 - 5 or the servicing PSC,
it is not detected in screening - process the RSI award and include the appropriate
totalization denial paragraph. Transfer the RSI folder to module 1 - 5 or the servicing
PSC, as appropriate
If the misrouted claim is a retirement, survivor, or disability claim, for which the
worker has less than six QCs, and it is detected in screening or later transfer the
RSDI folder to module 1 - 5 or the servicing PSC, as appropriate
If the misrouted claims is a disability claim in which the worker meets disability insured status based on U.S. coverage only and:
at least one claimant has a foreign address, send the folder to CDB or module 1 -
5 for review and processing
no claimant has a foregin address, return the folder to the FO for proper routing
if a disability determination has not been made. Send it to ODO or the PSC if a disability
determination has been made.