Prepare initial claims packages to request Polish certified coverage records and to
inform ZUS or KRUS about claims for Polish benefits.
Refer to GN 01752.025 – GN 01752.030
Prepare form SSA-e2960–U3-PL and forward it to ZUS or KRUS if the Polish record is
not in the claims file.
Prepare a claims package that includes:
Form SSA-e2960–U3–PL to request a Polish certified coverage record (PL/USA 6) if needed
and to certify the filing date for Polish benefits, establish factors of entitlement,
and U.S. benefit information.
A U.S. totalization earnings record.
Medical evidence from SSA’s files, if the Polish 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 and mail package if not received when tickle is due.
Any necessary proofs and evidence.
Letter to claimant advising them that their claim was forwarded to the ZUS /KRUS Agency
if claim is for Polish benefits only.
GN 01751.150 – GN 01751.225, Application and Evidence for Polish Agreement