Follow these steps for reviewing claims under the U.S / Republic of Poland Totalization
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:
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
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.
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.
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.
GN 01702.001 – GN01702.525, Development and Routing of Totalization Claims
GN 01751.150 – GN 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