An applicant filing for benefits under the Agreement with Switzerland must complete Form SSA-2490-BK (Application for Benefits Under a U.S. International Social Security Agreement). This is true whether the applicant is filing for benefits only from the United States, only from Switzerland, or from both countries.

In addition to Form SSA-2490-BK, an applicant for Swiss benefits must complete one or more special Swiss application forms. The form(s) will vary depending on the type of benefit. Field Offices (FO) do not take these application forms. After receiving a claim for Swiss benefits filed with SSA, the Swiss agency will:

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  Mail the appropriate Swiss application forms to the applicant; and

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  Include instructions for the applicant to complete the forms so the applicant can mail the forms directly to the Swiss agency (along with any additional required evidence).

Form SSA-2490-BK (Application for Benefits under a U.S. International Social Security Agreement) is available through MCS. The MCS version of Form SSA-2490-BK is an option for filing only when the number holder (NH) is filing for:

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  U.S. retirement or disability Totalization benefits only; or

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  U.S. retirement or disability benefits (regular or Totalization) and concurrently for Swiss benefits.

Do not use the MCS version of Form SSA-2490-BK when the applicant is filing for:

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  Swiss benefits only; or

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  U.S. or Swiss survivors benefits.

  Use the paper or electronic Form SSA-2490-BK for Totalization survivor claims. For instructions on how to complete the SSA-2490-BK, see GN 01702.110.

  NOTE: It is not necessary to take an SSA-2490-BK in claims for U.S. auxiliary benefits in life cases or in survivor cases where there was a previously approved award in a life case, since the NH previously completed one in connection with the previous application for benefits.

Along with the Form SSA-2490-BK, an applicant for Swiss benefits must complete one or more special Swiss application forms. The form(s) required vary depending on the type of benefit claimed. For example, Switzerland uses the Form CH/USA 2.3 (Application for Disability Insurance for Citizens of the United States of America Residing Outside Switzerland) for U.S. citizens not residing in Switzerland to claim disability benefits from Switzerland. The method of filing will also vary depending on whether the applicant is a Swiss citizen.

FOs do not take the special Swiss application forms. After receiving an application for Swiss benefits filed with SSA, the Swiss agency mails the appropriate Swiss application forms to the applicant. The Swiss agency instructs the applicant to complete the forms and mail them directly to the Swiss agency with any required evidence necessary in the application process.

If an applicant brings one of the Swiss application forms (or SSA-2490-BK) to the FO, the FO should:

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  Accept, photocopy, and certify the photocopied application; and

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  Photocopy and certify any additional documents (evidence) the Swiss agency requested the applicant to include with the Swiss claim; and

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  Request an "Informational/Certified Earnings Record" (ICERS) as described in MS 02101.004; and

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  Return to the applicant any original evidence documents and the certified photocopy of the application; and

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  Send the original Swiss application and any certified photocopies or additional claims material to the Division of International Operations (DIO) in Baltimore at the following address:

  Social Security Administration

  Division of International Operations

  P.O. Box 17769

  Baltimore, Maryland 21235-7769

  FAX number: 410-966-1861

  NOTE: If courier service is used, mail to:

  Social Security Administration

  Division of International Operations

  6100 Wabash Avenue

  Baltimore, Maryland 21215

  Once DIO receives the claim, they will send the claim directly to the Swiss agency along with the evidence and the worker's U.S. earnings record. DIO will annotate the MDW to show the type of claim and the date they forwarded the claim to the Swiss agency. When DIO receives the Form SSA-2490-BK, they will send a notice to the applicant explaining this requirement to file another application and referring the applicant to the nearest Swiss consulate or the Swiss Embassy if necessary. If the applicant is a non-Swiss citizen, advise the applicant that DIO will mail another application form to be completed and return to DIO..