TN 4 (04-22)

GN 01741.215 Application for Benefits under the U.S. - Korean Agreement

A. Filing for benefits using multiple application forms

1. Form SSA-2490-BK

An applicant filing for benefits under the U.S. - Korean Agreement must complete Form SSA-2490-BK (Application For Benefits Under a U.S. International Social Security Agreement), and any appropriate retirement, survivors or disability insurance application(s), and the special Korean application form. The Korean application form, along with instructions on how to complete the application, is available through the Totalization Benefits Resource Kit.

It is necessary to complete the Form SSA-2490-BK if the applicant is filing for any benefits under the Agreement: this could include benefits only from the United States, benefits only from Korea, or benefits from both countries.

An applicant who is filing for Korean benefits only, and NOT for benefits under the Agreement must complete the Korean application, but does not need to complete Form SSA-2490-BK.

2. Special Korean application forms

In addition to Form SSA-2490-BK, an applicant for Korean benefits under the U.S. - Korean Agreement must complete one or more special Korean application forms. SSA Field Offices (FO) do not accept special Korean application forms.

After receiving a claim for Korean benefits filed with SSA, the Korean agency will:

  • Mail the appropriate Korean application forms to the applicant; and

  • Include instructions for the applicant to complete the Korean application forms, so the applicant can mail the forms directly to the Korean agency (along with any additional required evidence).

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

Use the following information to determine which applications require completion (on select screens) when taking claims for U.S. Totalization benefits or Korean benefits under the Agreement with Korea.

1. When to use the Form SSA-2490-BK in MCS

Form SSA-2490-BK (Application for Benefits under a U.S. International Social Security Agreement) is available through MCS. The MCS version of Form SSA-2490-BK is an option for filing only when the number holder (NH) is filing for:

  • U.S. retirement or disability Totalization benefits only; or

  • U.S. retirement or disability benefits (regular or Totalization) and concurrently for Korean benefits.

2. When not to use the Form SSA-2490-BK in MCS

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

  • Korean benefits only; or

  • U.S. or Korean survivors benefits.

    Use the paper or electronic Form SSA-2490-BK for Totalization survivor claims. For instructions on how to complete the Form 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 the NH previously completed one in connection with his or her application for benefits. The MCS version of the Form SSA-2490-BK may not be used to file for U.S. Totalization survivors benefits. A paper or electronic (e-form) Form SSA-2490-BK must be used in this case.

3. Completing the required Form SSA-2490-BK screens in MCS

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

a. U.S. Totalization benefits only

  • In retirement or disability applications, complete the appropriate MCS application screens, the Totalization (TOTL) screen (see MS 03509.011), and the Form SSA-2490-BK screens (see MS 03507.001).

  • In survivor claims, complete the appropriate MCS application screens, the Totalization (TOTL) screen (see MS 03509.011) and Part I of the paper or electronic Form SSA-2490-BK.

b. Korean benefits only (regular or Totalization)

 

Complete Parts I and II of the paper or electronic Form SSA-2490-BK since applications for Korean benefits only (regular or Totalization) are MCS exclusions.

c. Korean benefits (regular or Totalization) and U.S. benefits (regular or Totalization)

  • For retirement or disability applications, complete the appropriate MCS application screens, the Totalization (TOTL) screen (See MS 03509.011), and the Form SSA-2490-BK screens (See MS 03507.001).

  • For survivors applications, complete the appropriate MCS application screens, the Totalization (TOTL) screen (see MS 03509.011), and both parts of the two-part paper or electronic Form SSA-2490-BK.

C. Field Office (FO) procedure for processing special application forms

 

1. The application process

Along with the Form SSA-2490-BK, an applicant for Korean benefits under the U.S. - Korean Agreement must complete one or more special Korean application forms.

FOs do not accept special Korean application forms.

The Korean application form, along with instructions on how to complete the application, is available through the Totalization Benefits Resource Kit.

2. Procedure for filing an application

If an applicant brings Korean special application form(s) (or Form SSA-2490-BK) to the FO, the FO should:

  • Accept, photocopy, and certify the photocopied application; and

  • Photocopy and certify any additional documents (evidence) the Korean agency requested the applicant to include with the Korean claim; and

  • Request an "Informational/Certified Earnings Record" (ICERS) as described in MS ICERS 02101.004; and

  • Return to the applicant any original evidence documents and the certified photocopy of the application; and

  • Send the original Korean application and any certified photocopies or additional claims material to the Division of International Operations (DIO) in Baltimore at the following address:

Social Security Administration
Division of International Operations
P.O. Box 17769
Baltimore, Maryland 21235-7769
FAX number: 410-966-1861

NOTE: If courier service is used, mail to:

Social Security Administration
Division of International Operations
6100 Wabash Avenue
Baltimore, Maryland 21215

Once DIO receives the claim, they will send the claim directly to the Korean agency along with the evidence and the worker's U.S. earnings record. DIO will annotate the MDW to show the type of claim and the date they forwarded the claim to the Korean agency.

When DIO receives the Form SSA-2490-BK, they will send a notice to the applicant explaining this requirement to file another application and referring the applicant to the nearest Korean consulate or the Korean Embassy if necessary. If the applicant is a non-Korean citizen, advise the applicant that DIO will mail another application form to him or her to complete and return to DIO.

D. References

  • 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 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/0201741215
GN 01741.215 - Application for Benefits under the U.S. - Korean Agreement - 04/15/2022
Batch run: 04/15/2022
Rev:04/15/2022