PROGRAM OPERATIONS MANUAL SYSTEMPart GN – GeneralChapter 017 – Totalization BenefitsSubchapter 02 – DO Development and Routing of Totalization ClaimsTransmittal No. 5, 07/25/2019
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.
Summary of Changes
GN 01702.520 Status Requests and Post-Adjudicative Actions in Totalization Claims
Per a request from the Office of Earnings and International Operations, we are changing all OIO references to DIO and changing the Office of International Operations (OIO) to the Division of International Operations (DIO).
Claims for U.S. Totalization benefits will take significantly longer to process than regular claims. This is due to the need to obtain the number holder’s (NH’s) foreign coverage record from the agreement country. In addition, due to systems limitations, all Totalization awards are processed manually.
When the Division of International Operations (DIO) forwards a claim for foreign benefits to the other country, it notifies the applicant of the date of forwarding and the address to which DIO sent the claim. In addition, DIO will annotate the date of forwarding to the foreign country on the Modernized Development Worksheet (MDW) screen.
When DIO requests a foreign coverage record in connection with a claim for U.S. Totalization benefits, it does not send any specific notice to the applicant advising him or her that the record has been requested. However, if the applicant has filed for both U.S. Totalization benefits and foreign benefits, DIO requests the foreign coverage record at the same time it forwards the foreign claim to the other country.
Do not follow up on claims for U.S. Totalization benefits or foreign benefits unless at least 9 months have elapsed since the claim was sent to DIO.
If a claim for foreign benefits has already been forwarded to the foreign agency, the applicant must follow up directly with the foreign agency.
Send a status request to DIO to follow-up on a claim for U.S. Totalization benefits.
When following up on the status of a claim for benefits from an agreement country, first check the MDW screen to see if DIO has already forwarded the foreign claim to the other country. If the MDW screen is annotated to show the claim has already been forwarded to the other country, advise the applicant to write directly to the agency identified on the notice he or she received from DIO. If the MDW screen does not indicate the claim has been forwarded to the other country, send a status request to DIO at the address in GN 01702.310C.