TN 3 (04-04)
GN 01721.220 Application Form for Spanish Benefits
All applicants for Spanish benefits must complete a special application form E/USA (Claim for Benefits Under the Spanish Legislation). This form is in a bilingual Spanish-English format and is available through the Totalization Benefits Resource Kit on the Intranet at http://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp .
B. Procedure – Required application for spanish benefits
The special Spanish application form is taken in the field offices (FO's). If an applicant wishes to file for Spanish benefits, the FO should:
Access the Totalization Benefits Resource Kit on the intranet at http://ocoweb.ba.ssa.gov/oio/Totalization/TotResKit.asp .
Print the Spanish application form (E/USA) and give it to the applicant for completion.
Provide any necessary assistance in completing the Spanish form.
NOTE: Most individuals filing for Spanish benefits should be able to complete the Spanish application form without assistance using the instructions provided with the application.
Photocopy and certify any documents (evidence) submitted by the applicant.
Send the Spanish E/USA form and the certified copies of evidence to the Office of International Operations (OIO) in Baltimore at the following address:
Complete the Modernized Development Worksheet (MDW) screen to show the date the claim was forwarded to OIO. Show “Totalization” as the ISSUE when completing the MDW screen.
Once OIO receives the claim, OIO will send the claim directly to the Spanish agency along with a copy of the applicant's U.S. coverage record.
C. Procedure – Status requests
When OIO forwards the completed Spanish application form, certified copies of evidence and a copy of the applicant’s U.S. coverage record, OIO annotates the MDW screen to show the type of claim, the date the claim was forwarded and that a notice was sent to the applicant.
Take the following steps if the applicant contacts the FO for the status of his or her claim for Spanish benefits:
Check the MDW screen to see if OIO has sent the claim to Spain.
If OIO hasn’t completed the MDW screen, advise the applicant to write directly to OIO at the address shown in GN 01721.220B.
If OIO has completed the MDW screen, advise the applicant to write directly to the Spanish agency shown on the notice he or she received from OIO when the claim was forwarded.
Forwarding applications for foreign benefits to the Office of International Operations, GN 01702.320