Effective Dates: 10/18/2022 - Present Previous | Next

TN 4 (10-22)

GN 01749.210 Developing Evidence in Claims for Czech Benefits

A. Introduction

This section shows the types of evidence used to support claims for Czech benefits.

B. Filing applications

Under the agreement with the Czech Republic, SSA will take applications for both regular and Totalization benefits on behalf of the Czech Republic and provide limited assistance in obtaining evidence needed to support the claim.

C. Using Evidence Submitted in Claim for U.S. Benefits

Evidence used to establish a factor of entitlement for U.S. Social Security benefits is used by the Czech Republic to establish the same factor for Czech benefits. The applicant will have to submit additional evidence to document a factor of entitlement for Czech benefits even if that factor has already been verified for SSA purposes.

D. Czech Entitlement Factors

The following indicates what factors of entitlement, in addition to insured status, must be established in claims for Czech benefits.

1. Retirement

An entitlement factor that must be established for Czech retirement claims is the age of the worker (age 63 ).

2. Survivors

Entitlement factors that must be established for Czech survivors’ claims are:

  1. a. 

    Death of worker,

  2. b. 

    Marriage, if surviving spouse's benefit is claimed, and

  3. c. 

    Age and relationship of child, if surviving minor child’s benefit is claimed.

3. Disability

Entitlement factors that must be established for Czech disability claims are:

  • •

    Age of worker,

  • •

    Degree of disability (medical evidence), and

  • •

    Age and relationship of child, if child’s benefit is claimed.

E. Claims Representative (CR) Procedure for developing evidence

Take the following actions when developing evidence to support claims for Czech benefits.

1. Types of evidence

If the applicant requests guidance on the type of evidence to submit, see guidance concerning:

GN 00302.000, Proof of Age

GN 00304.000, Proof of Death

GN 00305.000, Proof of Marital Relationship

GN 00306.000, Child Relationship and Dependency

2. Accepting evidence

  1. a. 

    Accept any evidence the applicant wishes to submit.

  2. b. 

    If the applicant does not want to release an original document, photocopy the evidence and certify the copy by using a verification stamp and signing that the document is a true and accurate copy.

  3. c. 

    Do not hold claims for Czech benefits for prolonged periods pending receipt of evidence.

  4. d. 

    If an applicant is unable to obtain needed evidence within a reasonable time, transmit the claim to the Division of International Operations (DIO) without the evidence.

  5. e. 

    Advise the applicant that the responsible Czech agency will contact the applicant directly regarding any evidence needed.

3. Documenting the file

Document the file showing that a factor of entitlement for a Czech benefit has been established for purposes of a U.S. claim.

a. Concurrent Title II/Czech claim

  • •

    Send the certified photocopy of the evidence with the Czech claim to DIO.

  • •

    Send the concurrent (fully insured) Title II claim to the appropriate program service center (PSC), PSC 1 through 6.

  • •

    Send the concurrent (Totalization) Title II claim to DIO, PSC 8. Address provided in GN 01749.210F.

b. Prior Title II claim

Include a master beneficiary record (MBR) printout in the claims file and send to DIO to show which factors, other than disability, have been established previously for purposes of a U.S. claim.

4. Obtain the number holder’s (NH's) U.S. coverage record

  1. a. 

    Obtain the NH's U.S. coverage record in all claims for Czech benefits.

  2. b. 

    When the applicant is filing for both U.S. and Czech benefits, complete the modernized claims system (MCS) screens. The MCS screens automatically generate a separate earnings record for the Czech claim.

  3. c. 

    When a claimant files for Czech benefits only, an MCS exclusion, request an Informational/Certified Earnings Record (ICERS) per MS 02101.004 , Informational/Certified Earnings Records – Totalization (ICIC).

  4. d. 

    Obtain proof of lag earnings if U.S. covered work in the lag period is alleged and the applicant is filing for any Czech benefit. (See RS 01404.005 through RS 01404.018 for proof of lag wages and RS 01804.100 for proof of lag self-employment income.)

F. Claims Representative (CR) Procedure for developing medical evidence

In addition to taking the actions in GN 01749.210E, take the following actions when developing medical evidence for Czech disability claims.

1. Czech benefits only

  1. a. 

    Accept any medical evidence the applicant wishes to submit when the claim is for Czech benefits only. Do not attempt to secure evidence for the applicant or offer advice as to what evidence is needed by the Czech Republic.

  2. b. 

    Send any medical evidence submitted, along with the claim to DIO (PSC 8) in Baltimore at the following address:

    Social Security Administration

    OEIO - DIO

    P.O. Box 17769

    Baltimore, Maryland 21235-7769
  3. c. 

    Transmit the file without medical evidence that is not readily available and advise the applicant that the Czech agency will contact the applicant directly for any evidence needed.

2. Czech benefits and concurrent Title II claim

Follow the instructions in GN 01702.400 through GN 01702.415 to process claims for Czech disability benefits and concurrent Title II disability claims.

G. References

MS 02101.004, Requesting an Informational/Certified Earnings Record - Totalization (ICIC)

MS 03509.011, Totalization (TOTL)

GN 00301.105, Certification of Evidence for Totalization Claims

RS 01404.005, Lag Period – and Lag Earnings

RS 01404.018, Evidence of Lag Wages

RS 01804.100, Establishing Lag SEI

GN 01749.215, Application for Benefits under the Czech Agreement

GN 01702.400, Developing Medical Evidence in Claims for U.S. Totalization Disability Benefits

GN 01702.405, Associating Evidence From Prior Disability Folders

GN 01702.410, Routing of Claims for U.S. Totalization Disability Benefits

GN 01702.415, Development of Medical Evidence and Routing of Claims for Foreign Disability Benefits

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201749210
GN 01749.210 - Developing Evidence in Claims for Czech Benefits - 10/18/2022
Batch run: 10/18/2022
Rev:10/18/2022