GN 01775.005 How the International Benefits and Processing Modules Review Claims under the U.S.- Romania Totalization Agreement
A. Reviewing claims under the U.S. - Romania Totalization Agreement
Follow these steps when reviewing claims under the U.S. - Romania Totalization Agreement:
•
1. Review the file for the required applications and evidence listed in GN
01765.010 through GN 01765.225;
•
2. Check the files for a U.S. totalization earnings record that can be sent to the Romanian liaison agency Territorial House of Pensions. If one is not in the file, request an ICERS record following the instructions in MS
02101.001 and MS 02101.004 for inclusion in the claims package to the liaison agency;
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3. Confirm all available medical evidence is included if the claim is for disability benefits; and
•
4. Once all eligibility requirements are met in accordance with GN 01765.210 (Developing Evidence and Establishing Entitlement Factors in Claims for U.S. and Romanian Benefits) send the claim package to the Romanian liaison agency:
National House of Public Pensions (NHPP) # 8 Latina Street,
2nd District
Bucharest Romania 020793
B. References
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· · GN 01765.010 through GN 01765.225 Applications and Evidence for the Romania Agreement
•
· · MS 02101.001 Informational/Certified Earnings Record Systems- Overview
•
· · MS 02101.004 Informational/Certified Earnings Records – Totalization – (ICIC)
GN 01775.010 How to Develop and Process Applications (Claims) Filed in the Federal Benefits Unit in Naples, Italy under the U.S.- Romania Totalization Agreement
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A. Processing applications filed in the Naples, Italy Federal Benefits Unit
(FBU)
The Naples Federal Benefits Unit (FBU) takes claims from applicants residing in Romania who file for U.S. - Romania totalization benefits. The FBU follows the same general procedures and obtains the same applications and evidence as SSA field offices (FO) when processing claims under the Agreement, but they cannot adjudicate claims.
•
B. Developing and routing of U.S. claims for U.S. benefits filed at the FBU in
Naples, Italy
The following development and routing instructions apply to U.S. claims for U.S. benefits filed at the FBU in Naples under the U.S.- Romania Agreement.
•
1. Development actions taken by the Naples FBU
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a. Retirement and
Disability
claims - worker not insured based solely on U.S. coverage
–
Contact the applicant to obtain Form
SSA-2490BK (Application for Benefits under a U.S. International Social
Security Agreement ) and any appropriate U.S. applications.
•
Forward Form SSA e2960 USA-RO 3 (U.S. - Romania Agreement on Social Security
Transmittal/Request/Certification ) and Part I and II of Form SSA-2490BK to the liaison agency in Romania to request coverage record;
•
Complete the appropriate MCS application screens including the Totalization (TOTL) Screen (see MS 03509.011 ) and SSA 2490 Screens (MS
03507.001 ); and
•
Develop for any evidence needed to complete the application process.
–
b. Survivor claims under the Agreement - worker not insured based solely on
U.S. coverage
•
Complete the appropriate MCS application screens, the Totalization (TOTL) Screen (see MS 03509.011 );
•
Complete Part 1 of Form-2490BK (Application for Benefits under a U.S.
International Social Security Agreement ) if the number holder's MBR is not already established with the Totalization agreement;
•
Forward Form SSA e2960 USA-RO 3 (U.S. Romania Agreement on Social Security
Transmittal/Request/Certification ) to the liaison agency in Romania to request a coverage record; and
•
Develop for any evidence needed to complete the application process.
•
2. Claim sent to the International Benefits and Processing (IBP) for
processing
When all documentation and Romanian foreign earnings record are received, forward the claim to IBP and include a copy of the completed liaison form sent to the Romanian liaison agency.
•
C. Handling claims for Romanian Benefits
Refer all inquiries for Romanian benefits received in the FBU in Naples, Italy to the Romanian liaison agency National House of Public Pensions. If an applicant contacts the Naples, Italy FBU to file for Romanian benefits, the FBU will send the Romanian liaison agency National House of Public Pensions the following:
•
Form SSA-e2960 USA/RO 3 (U.S.- Romania Agreement on Social Security
Transmittal/Request/Certification ) to certify the filing date for Romanian benefits and to certify established factors of entitlement such as date of birth;
•
U.S. coverage record; and
•
Available medical evidence (if the claim is for disability benefits).
For Romanian disability claims submitted in the United States, claimants must obtain medical evidence from U.S. health care providers and submit the evidence to the appropriate Romanian authorities. If the Romanian liaison agency needs additional information to process a claim for Romanian benefits, including a U.S. certified earnings record, entitlement information or both, they will request the information directly from the Naples FBU using Form SSA e2960 USA/RO 3 (U.S.- Romania Agreement on Social Security
Transmittal/Request/Certification).
GN 01775.012 How the Federal Benefits Unit in Naples, Italy Processes and Develops Claims Filled with the Romanian Liaison Agency
A. Romanian liaison agency processing of claim referrals for U.S. benefits to the
FBU
When an individual contacts the Romanian liaison agency National House of Public Pensions to file a claim for U.S. benefits, the liaison agency sends the following information to the Federal Benefits Unit (FBU) in Naples, Italy:
•
Form SSA e2960 USA/RO 3 (U.S.- Romania Agreement on Social Security
Transmittal/Request/Certification) certifying the filing date for the claim;
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Romanian certified coverage record;
•
Available medical evidence (if the claim is for disability benefits).
B. FBU processing referrals from the Romanian liaison agency
This procedure explains how the Naples, Italy FBU processes referrals from the Romanian liaison agency National House of Public Pensions.
1. Claimant entitled to U.S. benefits
Upload all material in Evidence Portal (EP) annotating “already entitled to U.S. benefits”.
2. Claimant not entitled to U.S. benefits
Follow the instructions in GN
01775.010B to process the claim.
C. References
•
GN
01775.010
How to Develop and Process Applications (Claims) Filed in the Federal Benefits Unit in Naples, Italy under the U.S. – Romania Totalization Agreement
A. Introduction to the Romanian liaison agency
The Romanian liaison agency National House of Public Pensions is the only Romanian social insurance agency that SSA will use to communicate and process the claims under the U.S. - Romania Totalization Agreement.
B. Requesting information from the Romanian liaison agency
When transmitting information to or requesting information from the Romanian liaison agency, use the Totalization Data Collection Program (TDCP) Form, SSA-e2960 USA-RO 3 Transmittal/Request/Certification, pre-addressed for all claims to:
National House of Public Pensions
8 Latina Street,
2nd District
Bucharest
Romania 020793 GN 01775.105 Romanian Certificate of Insurance Periods
Forwarding certificate of insurance periods
Romania will send the certificate of insurance with the RO-USA 3. The RO-USA 3 is the only acceptable form for the certification of the Romanian certificate of insurance periods. Forward certificate of insurance periods received in any other format to the International Support Unit (ISU) for approval.
GN 01775.110 How to Credit Quarters of Coverage Based on the Romanian Certificate of Insurance Periods
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A. Romanian certified coverage record
Use the Romanian certificate of insurance periods to assign foreign “F” quarters coverage to the U.S. coverage record.
•
There is no minimum amount of Romanian coverage, which must be earned before the U.S. can use it.
•
SSA will credit one quarter of coverage in a calendar year for every 90 days of coverage certified for that year by the liaison agency.
•
SSA will credit all periods of coverage based on paid contributions.
•
SSA will not credit months of coverage under Romanian laws that fall within a calendar quarter that SSA already credited as a U.S. quarter of coverage. For years after 1977, move the credited U.S. quarter of coverage in the quarter of the calendar year most favorable to the claimant.
1.
SSA will also not credit more than four quarters of coverage for any calendar year or consider periods of Romanian coverage credited prior to 1937 (the earliest year that U.S. law permits crediting periods of coverage).
•
B. Assigning Romanian coverage
Follow these steps to assign Romanian coverage:
1.
If the claimant is filing for disability benefits, credit all possible foreign quarters of coverage to the U.S. record.
1.
If the claimant is filing for retirement or survivor benefits, credit only the number of quarters required for insured status.
1.
To determine the maximum possible number of foreign quarters (F ) of coverage, divide the number of days in each insurance period by 90 (the number of days in a quarter). Consider any remainder to be one foreign quarter.
2.
If there is a period of coverage that begins or ends in the same calendar quarter as another period of coverage, determine the number of “F ” quarters for each period separately.
1.
Assign foreign quarters as follows:
•
Assign “ F” quarters for each creditable period shown on the Romanian coverage certification record starting with the calendar quarter in which the period begins and continuing consecutively until all foreign quarters are assigned;
•
Do not assign a foreign quarter in a calendar quarter where a U.S. quarter is already assigned. When a U.S. quarter is assigned in the same period with a Romanian period, do not give a foreign quarter for that period. Begin assigning foreign quarters again in the next available quarter.
•
For years prior to 1978, do not assign a foreign quarter in a calendar quarter where a U.S. quarter is already assigned. When a U.S. quarter is assigned in the same period with a Romanian period, do not give a foreign quarter for that period. Begin assigning foreign quarters again in the next available quarter.
•
For the years after 1977, assign existing U.S. quarters using the flexible crediting provision to permit assigning the maximum number of foreign quarters (RS
00301.230).
•
Do not skip over a foreign quarter assigned based on another Romanian period. If foreign quarters based on separate Romanian periods fall with the same calendar quarter, cancel one of the overlapping foreign quarters.
1.
Process the award (assuming all other entitlement factors are met) if the worker meets the minimum insured status requirements for U.S. totalization benefits after assigning Romanian coverage.
1.
If the worker does not meet the minimum insured status requirements based on combined coverage and the claim is for disability benefits or for survivor benefits, re-credit the foreign coverage. Follow step 5, except assign foreign quarters starting with the last available quarter of each period and continuing backwards consecutively until all foreign quarters are assigned.
2.
If the worker does not meet the minimum insured status for U.S. totalization benefits after crediting coverage, deny the claim.
RS
00301.230 Assignment of Quarters of Coverage
GN 01765.120 U.S. Totalization Benefits under the U.S. - Romanian Agreement
GN 01775.205 Preparing Claims Packages in the International Benefits and Processing (IBP) for Claims Filed Outside of Romania
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A. Initial Claims Packages
Prepare initial claims packages to request a Romanian certified coverage record and to inform the Romanian liaison agency, National House of Public Pensions, about claims for Romanian benefits.
Prepare Form SSA e2960 RO/USA 3 (U.S. - Romanian Agreement on Social Security
Transmittal/Request/Certification) and forward to the Romanian liaison agency Pension and Disability Insurance Institute of Romania if the Romanian certified record is not in claims file.
•
C. U.S. and Romanian claims or Romanian claim only
Prepare a claims package that includes:
•
Form SSA e2960 RO/USA 3 (U.S. - Romania Agreement on Social Security
Transmittal/Request/Certification ) to request a Romanian certified coverage record if needed. Use this form to certify the filing date for Romanian benefits, to establish factors of entitlement, and to give U.S. benefits information;
•
U.S. totalization earnings record;
•
Medical evidence from SSA’s files, if the claim is for disability benefits; and,
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Any other relevant evidence that Romania requires to take action on the claim.
GN 01765.010 through GN 01765.225 - Application and Evidence for Romanian Agreement
GN 01775.210 Preparing Claims Packages in International Benefits and Processing (IBP) for Claims Filed in Romania
A. U.S. claim only
Prepare a Form SSA e2960 USA/RO 3 (U.S. - Romania Agreement on Social Security
Transmittal/Request/Certification) if a Romanian certified coverage record is required and was not requested.
B. U.S. and Romanian claims or Romanian claim only
Prepare a Form SSA e2960 USA/RO 3 (U.S. - Romania Agreement on Social Security
Transmittal/Request/Certification) to:
1.
Request the Romanian certified coverage record; and
2.
Send the liaison agency National House of Public Pensions any information or documentation they may have requested.
GN 01775.220 Completing the Form SSA e2960 USA/RO 3 (U.S. – Romania Agreement on Social Security Transmittal/Request/Certification)
A. Using eForm SSA e2960 USA/RO 3
The International Benefits and Processing (IBP) and the Naples , Italy Federal Benefits Unit (FBU) complete the Form SSA e2960 USA/ RO 3 via the Totalization Data Collection Program (TDCP). Use the Form SSA e2960 USA/ RO 3 to:
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Transmit claims and related material to the Romani an liaison agency National House of Public Pensions ;
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Request information from the liaison agency; and
•
Respond to requests from the Romanian liaison agency.
B. Completing the eForm SSA e2960 USA/RO 3
Use the following information to complete eForm SSA e2960 USA/RO 3:
Item
|
Explanation
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Date of Original field
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Date automatically propagates
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Date(s) of Follow-ups field
|
Follow-up date(s) automatically propagates.
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To field
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Select the appropriate foreign agency.
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From field
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Office/Office Code and Fax numbers (if provided) automatically propagate based on user’s profile.
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1. Information about the claim
Complete the following information about the claim on the Form SSA e2960 USA/RO 3:
a.
Name of worker
Enter the first and last name(s) of the worker.
b.
Name of worker at birth
Enter the worker's name at birth if it has changed.
c.
Worker’s sex
Check the appropriate sex of the worker.
d.
Romanian birth registration number
Enter the Romanian birth registration number, if the number appears on the application or on the Romanian liaison form. If the claimant did not provide the Romanian birth registration number, indicate UNKNOWN in the Remarks field and provide the following information about the claimant.
e.
Worker’s U.S. Social Security Number (SSN)
Enter the worker’s U.S. SSN
f.
Claimant’s name
Enter claimant’s name.
g.
Claimant’s name at birth
Enter the claimant's name at birth if it has changed.
h.
Claimant’s U.S. SSN
Enter claimant’s U.S. SSN if he or she is not the worker entered in item A on the form.
i.
Claimant’s address and telephone number
Enter the complete address and telephone number of the claimant.
j.
Type of benefits claimed
On initial claims packages, indicate the type of claim for U.S. benefits and Roma nian benefits, both, in the appropriate columns.
k.
Date Claim Filed
Enter the filing date certified to the Roma nian liaison agency on all initial claims packages or in response to the agency’s request for the filing date.
l.
Certification of data
Complete the certification of data part of the form only when transmitting a claim for Roma nian benefits in response to the liaison agency request for specific information. If the requested information is not available, indicate “unknown”. If our records do not verify the known requested information, enter the information but do not check the “Verified” block.
m.
Name and date of birth
Enter the names of all claimants and, in survivor cases, the name of the deceased worker. Enter the date of birth (DOB) for all claimants and, for the deceased worker. Check the “Verified” block if SSA used the DOB to award U.S. benefits, or if the master beneficiary record (MBR) or Numident (NUMI) has a proof code for the DOB.
n.
Worker/Contributor’s date of death
Enter the deceased worker’s date of death in survivor claims. Check the “Verified” block if SSA used the date of death to award U.S. benefits, or if the MBR or NUMI has a proof code for the date of death.
o.
Date of Marriage
Enter the date of marriage if a spouse or surviving spouse is claiming benefits. Check the “Verified” block if SSA used the date of marriage to award U.S. benefits or if the MBR has a proof code for the date of the marriage.
p.
Date of Divorce
Enter the date of divorce if a divorced spouse or widow(er) is claiming benefits. Check the “Verified” block if SSA used the date of marriage to award U.S. benefits or if the MBR has a proof code for the date of the divorce.
q.
Country of birth
Enter the country of birth for the worker. Check the “Verified” block if SSA used the data to award U.S. benefits or if the MBR or NUMI has a proof code for the country of birth.
r.
Worker’s citizenship
Enter the country of citizenship of the worker. Check the “Verified” block if SSA used the data to award U.S. benefits or if the MBR or NUMI has a proof code for the worker’s citizenship.
2. Providing information to the Romanian liaison agency
When sending an initial claims package or responding to an assistance request, check all appropriate blocks to indicate the type of material being sent to the liaison agency.
a.
Certificate of Insurance Periods
Check this block when including a U.S. earnings record.
b.
Romanian Applications
Check the block when including Romanian applications.
c.
Medical Evidence
Check this block when including medical evidence that the claimant submitted or from SSA records.
d.
Date of information requested
Indicate the date of the liaison agency’s request if responding to a request.
e.
Other
If attaching material not covered by any block shown, briefly explain the attachment on the space provided for “Remarks”.
3. Information SSA needs from the liaison agency
When requesting information under the Agreement, check “Yes.” If “No” is checked, attach a consent statement. Check at least one block to indicate the type of material SSA is requesting from the liaison agency:
a.
Romanian certificate of insurance periods
Check this block to request the Romanian certificate of insurance periods.
b.
Medical evidence
Check this block to request medical evidence from the liaison agency
c.
Status of request date
Check this block to follow up on an earlier request sent to the liaison agency. Show the date of the original request in the space provided.
d.
Other
If requesting information not covered by items in GN
01775.220B.3.a. through GN 01775.220B.3.c in this subsection, briefly explain the request in the space provided for “Remarks”.
For “Remarks”, follow these guidelines:
Add only necessary remarks and ensure they are clear and concise. Do not use technical jargon or abbreviations. Technicians must enter their name in the signature block.
GN 01775.230 Controlling Requests Sent to the Romanian Liaison Agency on Form SSA e2960 USA/RO 3 (U.S.- Romania Agreement on Social Security Transmittal/Request/Certification)
Prepare a diary for information requested from the Romanian liaison agency National House of Public Pensions
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Diary initial request for 60 days;
•
Diary follow-up requests for 15 days; and
•
Notify your Module Manager (MM) if there is no response after 2 follow-ups.
GN 01775.235 Facts about the Romanian Liaison Form SSA e2960 USA/RO 3 (U.S. – Romania Agreement on Social Security Transmittal/Request/Certification)
When to use Form SSA e2960 USA/RO 3
The Romanian liaison agency National House of Public Pensions uses Form SSA e2960 USA/RO 3 to:
•
Transmit material to the International Benefits and Processing (IBP) or to the Naples, Italy Federal Benefits Unit (FBU);
•
Send information to IBP or to the Naples FBU; and
•
Request information from IBP.
GN 01775.305 Life to Death Conversions – Romanian Agreement
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A. Life to Death conversions
The Romanian liaison agency National House of Public Pensions requires that the survivor files an application and meets certain conditions to receive survivor’s benefits when a worker dies. There is no automatic conversion process.
GN
01703.260 How to Process Life to Death Conversions
GN 01775.310 The Romanian Liaison Agency Requests for Medical Examinations
•
A. Background for liaison agency requests a medical examination
If the Romanian liaison agency National House of Public Pensions requests a medical examination for a U.S. resident, the Social Security Administration (SSA) will schedule the examination and send the results to the liaison agency. The liaison agency requests medical examinations using the Form SSA e2960 USA/RO 3 (U.S. Romania Agreement on Social
Security Transmittal/Request/Certification).
•
B. Process for the liaison agency to obtain medical examinations
To obtain medical examinations for the liaison agency, use the following process:
•
1. Schedule an examination or forward pertinent medical evidence
SSA will schedule an examination, or forward “pertinent medical evidence” from SSA records to the liaison agency. Pertinent medical evidence is medical evidence that SSA obtained in connection with a continuing disability review or a disability claim filed or adjudicated within a year of the date for which the liaison agency has specifically requested medical evidence. SSA’s records include a paper claims folder and electronic files.
•
2. Requests reimbursement for cost of medical examinations
SSA requests reimbursements for the cost of medical examinations obtained for the liaison agency using Form SSA 1278 USA/RO 3 (Request for Payments of Reimbursable Expenses under
U.S. - Romania Agreement on Social Security). SSA will complete the form, scan it into electronic file and send a paper copy to the following address:
Address:
National House of Public Pensions 8 Latina Street, 2nd District Bucharest Romania
020793
NOTE:
Form 1278 USA/RO3 can be printed from the SSA Totalization Forms section of the International Benefits and Processing’s "Totalization Resource Kit ".
GN 01775.315 Romanian Unique Identifier
Romania introduced the Unique Identifier Code applied to all citizens. The Unique Identifier Code is a standard identification number.
The Unique Identifier Code consists of 13 digits as follows:
If the fist digit is number 1, identifies person as male.
If the first digit is 2, identifies person as female.
Followed by date of birth (DDMMYYRR) and the remainder is a 6-digit serial number.
Gender code and Date of birth
A foreign born male code is 7.
A foreign born female code is 8.
A male born from 2000 code is 5.
A female born from 2000 code is 6.
The Unique Identifier Code is a lifetime number for Social security, health, and pension for social programs with earnings and tax.
GN 01775.320 Romanian Medical Exam Reimbursement Form
The Romanian liaison agency National House of Public Pensions will use the SSA e2960 USA/RO 3 (U.S. - Romania Agreement on Social Security Transmittal/Request/Certification
Form) for reimbursement of medical expenses regarding requests for exams.
GN 01775.325 Social Security Administration (SSA) Medical Reimbursement Form
SSA uses the Form SSA 1278 USA/RO 5 (Request for Payments of Reimbursable Expenses
under U.S. - Romania Agreement on Social Security) for reimbursement of medical expenses regarding requests for exams.
The Form SSA 1278 USA/RO 5 (Request for Payment of Reimbursable Expenses under U.S.A.- Romania Agreement on Social Security) is available on the located on the SSA
Totalization Formssection of the International Operations, International Benefits and Processing, Totalization Resource Kit.
Mail the form to:
For Disability Claims:
National House of Public Pensions
#8 Latina Street,
2nd District,
Bucharest 020793