Identification Number:
GN 01752 TN 2
Intended Audience:See Transmittal Sheet
Originating Office:DCO OCO Center for Program Support
Title:OIO and FSP Processing Under the Agreement with Poland
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 017 – Totalization Benefits
Subchapter 52 – OIO and FSP Processing Under the Agreement with Poland
Transmittal No. 2, 06/22/2020

Audience

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

Originating Component

OCO

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 01752.025 Zaklad Ubezpieczen Spolecznych (ZUS) Liaison Agency

Hyperlink Removed

GN 01752.025 Zaklad Ubezpieczen Spolecznych (ZUS) Liaison Agency

A. Policy – Role of ZUS Liaison agency

Zaklad Ubezpieczen Spolecznych (ZUS) or Kasa Rolniczego Ubezpieczenia Spolecznego (KRUS) are the only Republic of Poland insurance agencies that will be used to communicate and process the agreement workload. ZUS is responsible for the Social Insurance Institution and KRUS is responsible for the Agricultural Social Insurance Institution of Poland. If periods of agriculture are alleged all applications go to KRUS for determination.

B. Procedure – transmit or request information from ZUS or KRUS

Transmit information to and/or request information from ZUS or KRUS via form SSA-e2960-U3–PL.

Use the following address and contact information for ZUS:

Zaklad Ubezpieczen Spolecznych (ZUS)
1 Oddzial ZUS w Warszawie
Wydzial Realizacji Umow Miedzynarodowych
Ul. Kasprowicza 151
01-949 Warszawa, Poland
Tel: 0-048-22-569-36-04
Tel: 0-048-22-569-36-74
Tel: 0-048-22-827-36-46
Fax: 0-048-22-827-53-71

This office investigates claims for benefits from ZUS under the Agreement for claimants residing in Poland, in the USA or in third country.

This office is responsible for PL/USA 4 (Retirement/Disability Application), PL/USA 5 (Survivor Benefit Application), PL/USA 7 (Request for Medical Evaluation), USA/PL 6 (ICERS), PL/USA 8 (Reimbursement for Medical Evaluation Expense) or PL/USA 10 (Burial/Funeral Benefit Application).

C. The role of ZUS under the Polish agreement

This office investigates claims for benefits from ZUS under the Agreement for claimants residing in Poland, in the USA or in third country.

This office is responsible for PL/USA 4 (Retirement/Disability Application), PL/USA 5 (Survivor Benefit Application), PL/USA 7 (Request for Medical Evaluation), USA/PL 6 (ICERS), PL/USA 8 (Reimbursement for Medical Evaluation Expense) or PL/USA 10 (Burial/Funeral Benefit Application).

D. Exhibits of Polish Totalization Forms

The following forms may be printed from the SSA Division of International Operations (DIO) Totalization Forms section of the Totalization Resource Kit:

  • SSA-e2960–U3–PL Transmittal Request Certification Form

  • PL/USA4 Request for Polish retirement – Annuity for Inability to Work

  • PL/USA5 Request for Polish Family Pension

  • SSA-USA/PL6, PL/USA6 Certificate Concerning Insurance Periods in Poland

  • PL/USA7 Medical Evaluation

  • PL/USA8 Request for Reimbursement for Medical Examination Expense

  • PL/USA10 Request for Payment of Polish Burial Allowance

 


GN 01752 TN 2 - OIO and FSP Processing Under the Agreement with Poland - 6/22/2020