GN 01753.215 Applications for Benefits Under the Agreement with the Slovak Republic
A. Filing for U.S. Totalization benefits
An applicant filing for benefits under the agreement with the Slovak Republic must complete Form SSA-2490-BK (Application for Benefits Under a U.S. International Social Security Agreement). The applicant must complete this form whether the application is for benefits from the United States only, the Slovak Republic only, or from both countries.
B. Using the Modernized Claims Systems (MCS) SSA-2490-BK
1. When you can use the MCS SSA-2490-BK
The SSA-2490-BK is available through MCS. Use the MCS version only when the number holder (NH) is filing for one of the following benefits:
2. When you cannot use the MCS SSA-2490-BK
Do not use the MCS version of the SSA-2490-BK when the applicant is filing for:
For instructions on how to complete the SSA-2490-BK, see GN 01702.110.
NOTE: If there is an existing U.S. Totalization life claim award, do not take an SSA-2490-BK in claims for U.S. auxiliary benefits or survivor claims.
C. Determining the required application screens on MCS for Totalization benefits
Use the following information to determine the application screens to complete when taking claims under the agreement with the Slovak Republic for U.S. Totalization benefits or Slovak benefits.
1. U.S. Totalization benefits only
a. Retirement and disability claims
Complete the following in retirement or disability claims:
b. Survivors claims
Complete the following in survivors claims:
2. Slovak benefits only (regular or Totalization)
Claims for Slovak benefits only (regular or Totalization) are MCS exclusions. Complete Parts I and II of the paper or electronic (eform) application Form SSA-2490-BK.
3. Slovak benefits (regular or Totalization) and U.S. (regular or Totalization) benefits
a. Retirement or Disability claims
In retirement or disability claims, complete the following:
b. Survivors claims
In survivors claims, complete the appropriate
D. Procedure for entering the Slovak birth registration numbers
Enter the worker's and each claimant's Birth Registration Number (BRN) on all claims. In Part I of the Form SSA-2490-BK, enter all the following information if the BRN is unknown. The Slovak agency will need this information to transmit the NH’s Slovak coverage record:
The worker’s full name, including both the paternal and maternal last names (see GN 00307.160).
The worker's employment history, including names of employers and dates of employment; and
The name of the agency to which the worker last contributed.
E. Procedure for required remarks
If the worker or a claimant presents his or her BRN card, document under remarks that the worker or claimant submitted this evidence.
MSOM MCS 007.001 Introduction to SSA-2490 - Overview
GN 01702.110 Application for Benefits Under a U.S. International Social Security (Totalization) Agreement (Form SSA-2490-BK)
GN 01702.320 Routing of Claims for Foreign Benefits