TN 1 (04-94)
GN 01716.235 Facts About the Ottawa Liaison Form CDN/USA 2
A. List of form CDN/USA 2 functions
Ottawa uses Form CDN/USA 2 to:
transmit claims and related material to border FOs.
send information requested by DIO or the border FOs to DIO.
request information from DIO.
B. Process — FORM CDN/USA 2
Most entries on the form are self explanatory with the exception of those specifically listed below:
1. Part 2.f.
Evidence of Coverage Periods
Ottawa checks this block when they are providing a record of Canadian coverage for someone who has filed for U.S. benefits.
When a person has no coverage in Canada, Ottawa enters a zero in the total block.
When coverage appears in this section for a year after the year of alleged disability onset, Ottawa will provide information if the coverage is based on work.
2. Part 2.g.
Certification of Data
Ottawa uses this section to certify the date claim filed and vital statistics data pertaining to the worker and his family taken from their records.
These dates will be used without further verification unless there is a material discrepancy with other evidence in file (See GN 01701.210).
3. Part 3
Information Required From United States
Ottawa has provided a statement at the beginning of the section which eliminates the need for a copy of the individual's consent before we can release the requested information.
Ottawa will provide a consent form require information about an individual who has not filed a claim under the agreement.
4. Part 3.c.
Ottawa checks the block to request a copy of medical evidence in DIO files.
If there is no medical evidence in file, the remarks portion of the SSA-e2960-U3-CQ will show, “No Medical Evidence in File.”
Do not request a medical examination.
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