TN 2 (09-85)

GN 01704.530 Medical Evidence

A. General

Send all medical evidence submitted by a claimant in support of a foreign claim to the foreign agency. (If a foreign agency requests medical evidence from our records and the records are in DIO, photocopy the evidence and send it. See GN 01704.810.) However, do not send SSA disability report forms, Forms SSA-5002 or SSA-795, correspondence scheduling appointments for medical exams or disability transmittal forms.

After photocopying original documents or certified photocopies, affix the certification stamp to the last page of the document, the exact number of pages of the document must be shown. Uncertified copies are placed after the certified material. Affix the DIO authentication stamp to the first and last pages of medical evidence sent to foreign agencies.

B. Italy

In addition to medical evidence from the folder, INPS requires that the doctor of a claimant living in the United States and filing for Italian disability benefits complete a medical report Form IT/USA SS-3. BETs will generally be responsible for sending the Form IT/USA SS-3 to claimants who are filing for disability benefits from Italy only; i.e., they have not filed a concurrent RSDI claim.

1. When to send a form IT/USA SS-3

Send a Form IT/USA SS-3 when:

  1. An application SSA-3954-BK-IT is received in DIO from a claimant for Italian disability benefits who is a U.S. resident; or

  2. A request is received from INPS asking DIO to obtain an application SSA-3954-BK-IT from a disability claimant, and INPS is not requesting a medical examination.

2. Who should send form IT/USA SS-3 to whom

Send a Form IT/USA SS-3 to U.S. residents claiming disability benefits from Italy (including disabled auxiliaries, except wives, listed on the SSA-3954-F8-IT). CSs generally will send the forms in concurrent RSDI/ totalization situations; BETs generally will send them in totalization only situations.

3. What to send

Send a Form IT/USA SS-3, a totalization addressed envelope and a paragraph similar to the one shown below on a totalization letterhead.

  • “The enclosed Medical Report is required by the Italian Social Security System (Istituto Nazionale della Providenza Sociale) to process your application for disability benefits from Italy. Please have your doctor (or the doctor of                 ) complete the report. Return it to this office in the enclosed self-addressed envelope which requires postage. We will forward it to the appropriate office in Italy. The report will not be used by the United States Social Security Administration.”

4. How to send

This is a simple action which may be done at the screening desk.

  1. Complete the SSN block on the IT/USA SS-3 in ink, manually—there is no need for typing but do be neat.

  2. Block print the claimant's address on the letterhead in the location which will show through on a window envelope. Also, show the current date in the upper right-hand corner.

  3. Send the forms directly to the disability claimant or the proper applicant. Only DIO stocks these forms. Therefore, do not ask a district office for assistance regarding these forms.

  4. Send the form at any time while processing the claim—the sooner the better.

  5. Annotate the folder that the form was sent, the date and your initials.

  6. DO NOT DIARY. DO NOT FOLLOWUP.

  7. DO NOT DELAY SENDING CLAIMS PACKAGES TO INPS. Indicate on the SSA-e2960-IT-U5 that the claimant has been asked to submit Form IT/USA SS-3.

5. Final action

If and when an IT/USA SS-3 completed by the doctor is returned to DIO, send the form to the INPS office with jurisdiction via a Form SSA-e2960-IT-U5. Do NOT make a photocopy for the folder.

C. Germany

Send medical evidence 1 year old or less unless:

  1. German agencies specify the years for which medical evidence is required; or

  2. The claimant indicates he or she is filing for retirement benefits from the FRG, in which case no medical evidence need be sent even if there is medical evidence in the RSDI folder.

D. All others

Send only medical evidence submitted by claimant (see A. above).


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