Identification Number:
GN 01715 TN 9
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODEPPIN
Title:Agreement With Canada
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 017 – Totalization Benefits
Subchapter 15 – Agreement With Canada
Transmittal No. 9, 04/16/2020

Audience

OCO-OEIO: BET, BIES, BTE, CIES, CTE, DSE, FCR, FDE, PETL, RECONE, RECONR, RECOVR;
FO/TSC: CS, CS TII, CSR, CTE, DRT, DT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ODEPPIN

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.

 

Summary of Changes

GN 01715.225 Completion of Application for Canadian Benefits Under the Agreement on Social Security Between Canada and the United States (CDN-USA 1)

Old Language: A - The CDN-USA 1 application form is available through the Intranet at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm and is designed for self-help use.

New Language: A - The CDN-USA 1 application form is available through the Intranet here and is designed for self-help use.

 

GN 01715.230 Completion of Application for Quebec Pension Plan Benefits Under the Quebec - United States of America Social Security Understanding (QUE/USA-1)

Old Language: A - The QUE/USA-1 application form is available through the Intranet at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm and is used to claim benefits from the Quebec Pension Plan (QPP).

New Language: A- The QUE/USA-1 application form is available through the Intranet here and is used to claim benefits from the Quebec Pension Plan (QPP).

 

GN 01715.325 Designated Border Office Processing of Canadian and U.S. Totalization Claims

Old Language:

C4 - After receiving the Canadian coverage record, determine if Totalization insured status is met using the Totalization Insured Status Worksheet available on the Intranet at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm .

C9 - Transmit the claim electronically and also mail the A-101 supporting documentation using the special routing form available at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm to the appropriate mod in OIO at the following address:

New Language:

C4 - After receiving the Canadian coverage record, determine if Totalization insured status is met using the Totalization Insured Status Worksheet available on the Intranet here .

C9 - Transmit the claim electronically and also mail the A-101 supporting documentation using the special routing form (available here) to the appropriate mod in OIO at the following address:

 

GN 01715.330 Completion of Forms SSA-2960-CA and SSA-2960-QC <Quote>Request/Transmittal/Certification Form</Quote> By Designated Border Offices

Old Language: A - Both forms are available through the Totalization Benefits Resource Kit on the Intranet at http://eis.ba.ssa.gov/eis/misc/resource-kits/resourcekits.htm and are in a bilingual English and French format.

New Language: A - Both forms are available through the Totalization Benefits Resource Kit on the Intranet here and are in a bilingual English and French format.

GN 01715.225 Completion of Application for Canadian Benefits Under the Agreement on Social Security Between Canada and the United States (CDN-USA 1)

A. Introduction

The CDN-USA 1 application form is available through the Intranet here and is designed for self-help use. Once at this Intranet address, select "Totalization Benefits" from the listing and on the next webpage select "Totalization Forms". A guide is also available through the Intranet that includes comprehensive instructions on how to complete the form.

B. Procedure - General

1. Completing form CDN-USA 1

Most individuals filing for Old-Age Security (OAS) and Canada Pension Plan (CPP) benefits should be able to fill out the CDN-USA 1 without assistance using the completion instructions provided with the application. Should a claimant require assistance in completing the form, refer to the item-by-item instructions starting on page 8 of the instruction guide.

2. Verification of eligibility factors

Sections 1 and 6 of the CDN-USA 1 each contain a block headed “FOR USE BY THE SOCIAL SECURITY ADMINISTRATION ONLY.” These blocks are completed only by staff in the Office of International Operations (OIO) or one of the designated border offices identified in GN 01715.320. The blocks are used to inform the Canadian agency which, if any, of the items identified in sections 1 and 6 have been verified for SSA purposes.

C. Procedure - completing SSA blocks — OIO or designated border offices only

1. Date of Receipt

Always complete the “DATE OF RECEIPT” to show the date claim filed. Enter the date the CDN-USA 1 is filed in the field office (FO) or, if applicable, an earlier protective filing date.

2. Verified By

Enter your initial in the “VERIFIED BY:” space.

3. Other Items

Make entries next to the dates in Sections 1 and 6 only if SSA has established the relevant date in connection with a concurrent retirement, survivors or disability claim, or the date was previously established in connection with a prior claim and the date is available from the master beneficiary record (MBR). When an alleged date has been proven for SSA purposes, check the box beside “AS STATED.” If SSA has established a date different than the one alleged by the claimant, check the box next to the blank line and enter the proven date on the line. The proper date should be entered in year, month, and day order. (EXAMPLE: if the date of birth is January 2, 1935, enter 1935/Jan/02.) If SSA has not established an alleged date, make no entry by that date. If any entries are made next to the dates in Section 6, enter your initials in the “VERIFIED BY:” space.

Note: When a designated border office or OIO indicates in Section 1 or 6 that a particular factor has been established for SSA purposes, it is not necessary to send to the Canadian agency photocopies of evidence used to establish that factor.

GN 01715.230 Completion of Application for Quebec Pension Plan Benefits Under the Quebec - United States of America Social Security Understanding (QUE/USA-1)

A. Introduction

The QUE/USA-1 application form is available through the Intranet here and is used to claim benefits from the Quebec Pension Plan (QPP). The form is in a bilingual English and French format.

B. Procedure - Entering dates on Quebec application form QUE/USA-1

Enter dates on the QUE/USA-1 as follows:

  • enter the date in year, month, day order (or, where applicable, year, month order)

  • print the first 3 letters of a month rather than its numerical equivalent.

Example: If the date of birth is January 2, 1935, enter 1935/Jan/02.

C. Procedure - Completing Quebec application form QUE/USA-1

Use the following information to complete those items on the Quebec application form QUE/USA 1 that are not self-explanatory.

1. Part A - General Information About the Contributor

Complete Part A in all claims for QPP benefits. Include general information about the worker (contributor).

  • Item 1 - Check either French or English even if the applicant has no preference. If the last Canadian province in which the worker lived was Quebec, the QPP has jurisdiction; otherwise, the Canada Pension Plan (CPP) has jurisdiction and the applicant should complete the CDN-USA 1 rather than the QUE/USA-1.

  • Item 7 - If separated, enter the date the worker and the spouse began living apart, regardless of whether legally separated at the time.

  • Item 10 - Include natural, adopted or stepchildren of the worker, regardless of age or marital status of the children.

2. Part B - Application for a Retirement Pension

Complete Part B if the applicant is applying for a retirement benefit.

3. Part C - Application for Disability Benefits

Complete Part C if the applicant is applying for a disability benefit.

4. Parts D and E - Application for Survivors' Benefits

Complete Parts D and E if the applicant is applying for survivor's benefits.

5. Part F - Declaration of the Person Making the Application

Complete Part F in all claims for QPP benefits. The applicant must sign and date the application.

  • Where the applicant signs by mark, the signature must be witnessed.

  • If the application is signed in the presence of an SSA employee, the SSA employee may sign as witness and enter the field office (FO) address.

6. Part G - This Part is to be Completed by the Competent Institution of the United States of America

This section is completed only by staff in the Office of International Operations (OIO) or one of the designated border offices (at the Claims Representative level or higher) identified in GN 01715.320. It informs the Quebec agency which, if any, of the eligibility factors shown have been verified for SSA purposes.

  • Always enter the date claim filed in the first block. This date will be the date of filing in the FO or an earlier protective filing date, if applicable.

  • Make entries in the remaining blocks only if the relevant date has been established for SSA purposes either in connection with a

    • concurrent retirement, survivors or disability claim, or

    • prior claim and the date is available from the master beneficiary record (MBR).

  • For each date established by SSA, enter the date in the appropriate space and check the “Verified” box. (The date that has been proven for SSA purposes is entered even if different than the alleged date.)

  • If SSA has not established a particular date, make no entry.

  • When surviving spouse's benefits are claimed, enter the surviving spouse's name and date of birth (if established for SSA purposes) in the appropriate space and check the “Verified” box.

  • Enter any children's names and dates of birth (if established for SSA purposes) in the appropriate spaces and check the “Verified” box.

  • Enter the name and address of the office in the space designated “Name of the Institution” (e.g., SSA field office, Burlington, Vermont).

  • Sign and date in the space provided and also print the name and title of the individual completing this section.

  • Stamp the section in the space provided with the date stamp used to date stamp applications for U.S. benefits.

GN 01715.325 Designated Border Office Processing of Canadian and U.S. Totalization Claims

A. Policy

1. Canadian Benefits

When a person files an application for Canadian benefits in one of the designated border offices listed in GN 01715.320, that office is responsible for verifying certain eligibility factors for Canada and transmitting a liaison package to the Canadian agency in Ottawa and/or Quebec City.

2. U.S. Totalization Benefits

When a person files an application for U.S. Totalization benefits under the Canadian agreement in a designated border office and has at least 6 U.S. quarters of coverage (QC's) but not enough to be insured, the office should request a record of the worker's Canadian coverage from the appropriate Canadian agency. The record of Canadian coverage is requested using either form SSA-2960-CA or SSA-2960-QC (see GN 01715.330).

B. Procedure - Canadian Benefits

Process claims for Canadian benefits filed in designated border offices according to the following table:

Application Filed For

Documentation Required

Route Material to

Old-Age Security (OAS) only or Canada Pension Plan (CPP) only or OAS and CPP only

CDN-USA 1, SSA-2960-CA, U.S. earnings record, if required (see GN 01715.210E.4.), any other evidence submitted

Ottawa

Quebec Pension Plan (QPP) only

QUE/USA-1, SSA-2960-QC, U.S. earnings record, if required (see GN 01715.210E.4.), any other evidence submitted

Quebec

OAS and QPP

CDN-USA 1, SSA-2960-CA, SSA-2960-QC, U.S. earnings record, if required (see GN 01715.210E.4.)

 

NOTE: If an earnings record is being sent to both Ottawa and Quebec, it will be necessary to send a certified photocopy to one location.

Any other evidence submitted

Ottawa:

CDN-USA 1

SSA-2960-CA

U.S. earnings record

related evidence

 

Quebec:

QUE/USA-1

SSA-2960-QC

U.S. earnings record

related evidence

C. Procedure - U.S. Totalization Claims

Process claims for U.S. Totalization benefits filed in designated border offices according to the following instructions:

  1. 1. 

    Enter the claim into the modernized claims system (MCS).

  2. 2. 

    Process the initial insured-status denial.

  3. 3. 

    Request the Canadian coverage record by completing SSA-2960-CA or SSA-2960-QC via the Totalization Data Collection Program.

    • Use the border office's customized transmittal form SSA-2960-CA or SSA-2960-QC.

    • Mail correspondence from the USA directly to the New Brunswick office to the following address:

      Service Canada
      P.O. Box 250 STN A
      FREDERICTON NB E3B 4Z6
      CANADA
    • Fax correspondence from the USA to the following fax numbers:

      • Canada (New Brunswick) 506-452-3415

      • Quebec 514-873-1811

      • Ottawa – 613-952-8901

    • Faxes sent from the USA (i.e. urgent SSA liaison responses, and non-urgent requests) should be faxed directly to the New Brunswick office fax number above.

    • Continue to fax the Ottawa office, only if the fax is in response to a Canadian Liaison request originating from Ottawa. Also, if the information needed from Canada is an urgent request, contact the Ottawa Office at the fax number above.

    • Diary the request for 3 months.

    • Canada will send response by mail.

    • If your request is marked “2nd Request,” Canada will respond by fax. Be sure to wait 3 months before sending 2nd request.

    • Diary the 2nd request for 30 days.

    • If your request is a “3rd Request,” Canada will respond by fax. Be sure to wait 30 days before sending the 3rd request.

    • Diary the 3rd request for 15 days.

    • Contact Ottawa/Quebec directly for any special problems.

    NOTE: Only mark requests as “Urgent” if the claimant is terminal, in dire need, or no response has been received after the 3rd request. Send requests for Canada (New Brunswick and Ottawa) to the Ottawa Office at the above fax number. If request is for Quebec, send to Quebec at the above fax number.

  4. 4. 

    After receiving the Canadian coverage record, determine if Totalization insured status is met using the Totalization Insured Status Worksheet available on the Intranet here .

  5. 5. 

    If yes, compute the Totalization primary insurance amount (PIA) and the monthly benefit amount (MBA) using the online computation available through the Title II Inter Active Computation Screen.

  6. 6. 

    Reenter the claim into MCS using the Automated SSA-101 process (see MSOM MCS 014.001 ). Add pertinent Totalization information as well as relevant paragraphs and remarks.

  7. 7. 

    MCS will not allow clearance of the claim for U.S. Totalization until the path for the SSA-2490 is entered. Complete the first (FINF) screen and print that screen.

  8. 8. 

    Complete form e4962, “Totalization Data Collection Form” (see GN 01703.710).

  9. 9. 

    Transmit the claim electronically and also mail the A-101 supporting documentation using the special routing form (available here) to the appropriate mod in OIO at the following address:

    Social Security Administration
    OIO Totalization
    P.O. Box 17769
    Baltimore, Maryland 21235-7769

D. Procedure - Exceptions to Automated SSA-101 Processing

The following types of claims for U.S. Totalization benefits cannot be processed in designated border offices:

  • Claims involving railroad coverage;

  • Insured status disallowances where the worker is not insured after U.S. and foreign coverage are combined;

  • Totalization status code (TSC): E-2 claims - worker attains insured status based solely on U.S. coverage, but existing Totalization PIA is higher than non-Totalization PIA;

  • Claims that are MCS exclusions; and

  • Claims involving the windfall elimination provision (WEP) that have a month of entitlement prior to 1/95.

These claims for U.S. Totalization benefits should be sent to OIO at the address shown in GN 01715.325C for processing.

E. References

GN 01715.330 Completion of Forms SSA-2960-CA and SSA-2960-QC Request/Transmittal/Certification Form By Designated Border Offices

A. Introduction

Forms SSA-2960-CA and SSA-2960-QC are used only by the designated border offices and the Office of International Operations (OIO). Both forms are available through the Totalization Benefits Resource Kit on the Intranet here and are in a bilingual English and French format. SSA-2960-CA is further identified by the designation USA/CAN 3 (É-U/CAN 3) in the upper right hand corner and is addressed to the Income Security Programs Branch in Ottawa. SSA-2960-QC is further identified by the designation USA/QUÉ 3 (É-U/QUÉ 3) in the upper right hand corner and is addressed to the Régie des rentes du Québec in Québec City. Complete these forms via the Totalization Data Collection Program (TDCP).

B. Policy - Transmittal form SSA-2960

Designated border offices must complete the appropriate transmittal form SSA-2960:

  • to route applications for Canadian benefits (the CDN-USA 1 or QUE/USA-1) and associated material to the Canadian agencies in Ottawa or Quebec; or

  • if an applicant has filed for U.S. Totalization benefits and it is necessary to request a Canadian coverage record from Ottawa or Quebec because the worker has at least 6 U.S. credits but not enough to be insured.

C. Procedure - Completing transmittal form SSA-2960

Use the following information to complete those items on the transmittal form that are not self-explanatory. Complete forms via the Totalization Data Collection Program (TDCP). When entering dates, write out the name of the month rather than showing the date entirely in numbers, e.g. March 2, 2003 rather than 3/2/2003.

1. From section

Check the first block and include the 3-digit code of the designated border office when completing the OIO form and include the office's mailing address or use the border office's customized form which includes the border office's full mailing address.

2. Information about the claim

a. Name of Number Holder (NH)

Enter the name of the person on whose record the claim is based. Do not enter the name of the applicant unless the applicant is also the NH. If the NH is deceased, enter “Deceased” after the name.

b. Canadian Social Insurance (SIN) or Old-Age Security (OAS) Number

Enter the 9-digit Canadian SIN number (all numeric) separated into 3 groups of 3 numbers each. If unknown, enter “Unknown” in the appropriate space and enter the NH's father's name and mother's maiden name in the appropriate spaces.

Enter the 11-digit Canadian OAS number (all numeric). The last 9 digits are the same as the Canadian Social Insurance number. If unknown, enter “Unknown” in the appropriate space.

c. Address of Claimant

If the NH is deceased, enter the NAME of the claimant as well as the address of the claimant.

d. Telephone Number

Always enter the claimant's telephone number, if known.

e. Type of Benefits Claimed

Check the appropriate block(s) to indicate from whom benefits are being claimed as well as the type(s) of benefit being claimed.

f. Date Claim Filed

Enter the date the claim was filed using month, day, and year format. When entering the date, write out the name of the month rather than showing the date in numbers, e.g. March 2, 2003 rather than 3/2/2003.

3. Certification of Data

When entering dates, write out the name of the month rather than showing the date in numbers, e.g. March 2, 2003 rather than 3/2/2003.

4. Information Provided

If the SSA-2960 is being used to transmit material to Ottawa and/or Quebec, check the appropriate block(s) to identify the material.

NOTE: When the claimant has submitted a document that must be sent to both Ottawa and Quebec, prepare a certified photocopy for both agencies.

5. Information Required

Designated border offices should check only blocks a) “Evidence of Coverage Periods” or e) “No Information Required.” No other block should be checked.

6. Remarks

Keep remarks to a minimum. When needed, remarks should be clear and concise. Don't use technical jargon or abbreviations.

NOTE: Canada may need to develop a worker's lag earnings under the Canadian system. Therefore, list any Canadian work alleged by the worker during the current or preceding calendar year in the Remarks section.

7. Signature

A Claims Representative (CR) or higher should sign the form in the space provided and also print the name and title of the individual completing this form. The date and SSA seal will be automatically inserted on the form.

D. Procedure - Disposition of transmittal form SSA-2960

If a U.S. claim (regular or Totalization) is filed, print two copies of the completed Form SSA-2960. Send one copy of the completed form to Ottawa and/or Quebec and keep the other copy of the completed form with the U.S. claim.

E. References

  • Application for Canadian benefits, GN 01715.220

  • Designated border offices, GN 01715.320

  • Forms SSA-2960-CA and SSA-2960-QC “Request/Transmittal/Certification Form,” GN 01716.220


GN 01715 TN 9 - Agreement With Canada - 4/16/2020