Basic (07-09)

GN 01752.005 How DIO Modules Review Claims under the U.S. / Republic of Poland Totalization Agreement

A. Procedure – for reviewing claims under the Polish Agreement

Follow these steps for reviewing claims under the U.S / Republic of Poland Totalization agreement:

  1. 1. 

    Review the file for the required applications and evidence listed in GN 01752.205 - GN 01752.220.

    If the person is filing for Polish benefits and the “Claim for A Pension from the Republic of Poland (PL/USA 4) is not in file, mail the appropriate application form with instructions to mail the completed form directly to Zaklad Ubezpieczen Spolecznych (ZUS) or Kasa Rolniczego Ubezpieczenia Spolecznego (KRUS) agency below:

    Zaklad Ubezpieczen Spolecznych (ZUS)
    1 Oddzial ZUS w Warszawie
    Wydzial Realizacji Umow Miedzynarodowych
    1st Branch Office in Warsaw
    Ul. Kasprowicza 151
    01-949 Warszawa, Poland
    Kasa Rolniczego Ubezpieczenia Spolecznego (KRUS)
    Oddzial Regionalny w Krakowie
    Ul. Mlynska 8
    33-300 Nowy Sacz, Poland

    NOTE: Claim for a Pension from ZUS or KRUS (PL/USA 4) may be printed from the SSA Totalization Forms section of the Totalization Resource Kit in the Division of International Operations (DIO) website.

  2. 2. 

    Check the file for a U.S. totalization earnings record that can be sent to ZUS or KRUS. If one is not in file, request an ICERS record following the instructions in MSOM ICERS 001.001 and MSOM ICERS 001.004 for inclusion in the package to ZUS or KRUS.

  3. 3. 

    Confirm that all available medical evidence has been included if the claim is for disability benefits. In addition, if a completed physician’s medical evaluation report (PL/USA 7) is not included, follow up with the claimant 7 days after receipt of application. Tickle for 53 days to provide the evaluation report to SSA and mail claims package when tickle is due to the Polish agency.

  4. 4. 

    When all required material is in file, prepare a claims package for the Republic of Poland according to the guidelines in GN 01752.205 - GN 01752.210.

B. References

  • GN 01702.001 – GN01702.525, Development and Routing of Totalization Claims

  • GN 01751.150GN 01751.225 Applications and Evidence for the Republic of Poland Agreement

  • MSOM ICERS 001.001 – Informational/Certified Earnings Records Systems

  • MSOM ICERS 001.004 - Informational/Certified Earnings Records – Totalization

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GN 01752.005 - How DIO Modules Review Claims under the U.S. / Republic of Poland Totalization Agreement - 05/01/2017
Batch run: 10/15/2018