The special Japanese application forms are taken in the field offices (FO). If an
applicant wishes to file for Japanese benefits, the FO should:
Access the Totalization Benefits Resource Kit on the intranet at http://ocoweb/oio/Totalization/TotResKit.asp
Print the appropriate Japanese application form (J/USA 1 or J/USA 2) and instructions
and give them to the applicant for completion.
Provide any necessary assistance in completing the Japanese form.
NOTE: Most individuals filing for Japanese benefits should be able to complete the Japanese
application form without assistance using the instructions provided with the application.
Request an “Informational/Certified Earnings Record” (ICERS) per MSOM ICERS 001.004.
Photocopy and certify any documents (evidence) submitted by the applicant.
Send the completed Japanese application form, certified copies of evidence and certified
earnings record(s) (ICERS) to the Office of Earnings and International Operations
(OEIO)/Division of International Operations (DIO) in Baltimore at the following address:
Social Security Administration
P.O. Box 17769
Baltimore, Maryland 21235-7769
Complete the Modernized Development Worksheet (MDW) screen to show the date the Japanese
claim is forwarded to OEIO/DIO. Show “Totalization” as the ISSUE when completing the
Once OEIO/DIO receives the claim, OEIO/DIO will send the claim directly to the Japanese
agency along with the evidence and the worker’s U.S. coverage record.