Effective Dates: 04/12/2023 - Present Previous | Next

TN 6 (04-23)

GN 01727.215 Application for Benefits under the U.S. - Portuguese Agreement

A. Filing for benefits using multiple application forms

All applicants filing for benefits under the Agreement with Portugal 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 Portugal, or from both countries.

B. Using the Modernized Claims System (MCS) version of Form SSA-2490-BK

1. When you may use the MCS version

The SSA-2490-BK is available through MCS, but you may only use the MCS version when the number holder (NH) is filing for:

  • •

    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 Portuguese benefits.

2. When you may not use the MCS version

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

  • •

    Portuguese benefits only; or

  • •

    U.S. or Portuguese survivors benefits.

You must use a paper or electronic (e-form) Form SSA-2490-BK for Totalization survivor claims. Form SSA-2490-BK is also available through the Totalization Benefits Resource Kit. For instructions on how to complete the SSA-2490-BK, see GN 01702.110.

NOTE: It is not necessary to take a Form 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 this application would have been completed previously in connection with the NH's claim.

C. Determining the required MCS application screens for Totalization benefits

Use the following information to determine the application screens to complete when taking claims under the U.S. - Portuguese Agreement for Totalization or Portuguese benefits.

1. U.S. Totalization benefits only

a. Retirement or disability claims

Complete the following screens:

  • •

    MCS application; and

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    Form SSA-2490-BK (MSOM) see MS 03507.001); and

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    TOTALIZATION (TOTL) see MSOM MS 03509.011.

b. Survivors claims

Complete the following screens:

  • •

    MCS application; and

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    TOTALIZATION (TOTL) see MSOM MS 03509.011; and

  • •

    Part I of the paper or electronic Form SSA-2490-BK.

2. Portuguese benefits only (regular or Totalization)

Claims for Portuguese benefits only (regular or Totalization) are MCS exclusions. Complete Part I and II of the paper or electronic (e-form) application Form SSA-2490-BK.

3. Portuguese benefits (regular or Totalization) and U.S. (regular or Totalization) benefits

a. Retirement or disability claims

In retirement or disability claims, complete the following screens:

  • •

    Form SSA-2490-BK (See MSOM MS 03507.001); and

  • •

    TOTALIZATION (TOTL) see MSOM MS 03509.011.

b. Survivor claims

In survivor claims, complete the following screens:

  • •

    MCS application; and

  • •

    TOTALIZATION (TOTL) see MSOM MS 03509.011; and

  • •

    Parts I and II of the paper or electronic Form SSA-2490-BK.

NOTE: Form SSA-2490-BK is available through the Totalization Benefits Resource Kit.

D. Entering the worker's name

Enter the worker's complete name in item 1(a) of Form SSA-2490-BK. If the worker is Portuguese, the name will be shown on an official Portuguese document such as a passport or identity card. In the event the worker's name will not fit in item 1(a) of Form SSA-2490-BK, use the “Remarks” section.

E. Cause of disability

If the person is claiming disability benefits from Portugal, enter in the “Remarks” section of Form SSA-2490-BK whether or not the claimants disability resulted from a job-related injury. (Portugal needs this information to determine if it should pay the claim under worker's compensation rather than the disability program.)

F. References

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    GN 01702.110, Application for Benefits under a U.S. International Social Security (Totalization) Agreement (Form SSA-2490-BK).

  • •

    GN 01702.310, Routing of Claims for U.S. Benefits Involving Totalization.

  • •

    MS 03507.001, Introduction to Form SSA-2490-BK - Overview.

  • •

    MS 03509.011, Totalization (TOTL) screen.

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201727215
GN 01727.215 - Application for Benefits under the U.S. - Portuguese Agreement - 04/12/2023
Batch run: 04/18/2023
Rev:04/12/2023