BASIC (10-93)

GN 01724.205 Preparing Claims Packages for Claims Filed Outside France

A. Introduction

Claims packages are prepared to request French coverage and medical evidence and to inform the Center for Social Security for Migrant Workers about claims for French benefits.

B. Procedure

Include the following information in claims packages:

1. U.S. Claim

  • SSA-e2960-U3-FR (check item VI—coverage record to request a French coverage record).

  • A work history statement if the worker is not a French beneficiary.

2. U.S. and French Claim

Include the following information in claims packages:

  • SSA-e2960-U3-FR (check item VI—coverage record to request a French coverage record).

  • U.S. Earnings Record.

  • Parts I and II of the Disability Annex (USA/FR 3a) if the French claim is for disability benefits.

  • Medical evidence from the DIO file if the French claim is for disability benefits.

  • Medical Report Form (SE 404-4) if there is no pertinent evidence in DIO file to be included in the package.

  • A work history statement if the worker is not a French beneficiary.

3. French Claim

Include the following information in claims packages:

  • SSA-e2960-U3-FR.

  • U.S. Earnings Record.

  • Parts I and II of the Disability Annex (USA/FR 3a) if the French claim is for disability benefits.

  • Medical evidence from the DIO file if the French claim is for disability benefits.

  • Medical Report From (SE 404-4) if there is no pertinent medical evidence in DIO files to be included in the package.

C. Reference

  • Evidence Required for U.S. Totalization Benefits,
    GN 01723.205

  • Developing Evidence in Claims for French Benefits,
    GN 01723.210


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201724205
GN 01724.205 - Preparing Claims Packages for Claims Filed Outside France - 03/06/2017
Batch run: 03/06/2017
Rev:03/06/2017