TN 1 (04-94)

GN 01716.240 Facts About the Quebec Liaison Form QUE/USA 2

A. List of form QUE/USA 2 functions

Quebec uses Form QUE/USA 2 to:

  • transmit claims and related material to the four border FOs which service Quebec.

  • send information requested by OIO or the border FOs to OIO.

  • request information from OIO.

B. Process — Form QUE/USA 2

Most entries on the form are self explanatory with the exception of those specifically listed below:

1. Part 2

CERTIFICATION OF DATA - A) FAMILY MEMBERS, B) EVENTS

  • Quebec uses this section to certify data taken from their records pertaining to the worker and his family. Also contained in this section is the date a disability onset was established under QPP regulations.

  • These dates will be used without further verification unless there is a material discrepancy with other evidence in file. (See GN 01701.210 regarding verification of eligibility factors by foreign agencies.)

2. Part 3

INFORMATION PROVIDED BY D.A.E.S.S.

  • Quebec checks the appropriate blocks to show information that they are providing with this liaison form.

  • Periods of coverage - The periods of Canadian coverage are listed on the right hand side of this section when someone has filed for U.S. benefits.

  • When coverage appears in this section for a year after the year of alleged disability onset, RRQ should be contacted to determine if the coverage is based on work.

  • When a person has no coverage in Canada, Quebec enters a zero in the total block.

  • The filing date of the current application is hand written in the space to the right of the heading, “Information Provided by D.A.E.S.S.”

3. Part 4

REMARKS

  • Quebec enters an earlier protective filing date in this section if the claimant had previously filed for QPP benefits and indicated U.S. coverage on that application.

  • If the two filing dates would result in different months of entitlement, the date which provides the greatest advantage to the claimant should be used.

4. Part 5

INFORMATION REQUIRED BY REGIE DES RENTES DU QUEBEC

  • Quebec has provided a statement at the beginning of this section which indicates whether the information requested below is needed to process a claim under the agreement. If “YES” is checked, this eliminates the need for a copy of the individual's consent before we can release the information.

  • If no is checked, be sure a consent statement is obtained before releasing the information.

C. PROCEDURE — RESPONDING TO RRQ REQUESTS

Use the QUE/USA 2 to respond to RRQ requests for information instead of preparing a new SSA-2960-U3-CQ. To do this:

  • Reverse the heading of the “TO”/“FROM” blocks at the top of the form,

  • Staple the requested material to the QUE/USA 2,

  • Place the material in an envelope addressed to the RRQ. Use a pre-printed label to address the envelope.

D. Exhibit

G-QUE-USA-2-1

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G-QUE-USA-2-2

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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201716240
GN 01716.240 - Facts About the Quebec Liaison Form QUE/USA 2 - 03/26/2014
Batch run: 03/26/2014
Rev:03/26/2014