Basic (02-94)
When a U.S. claim is filed with a Luxembourg agency, the agency forwards Form LUX/USA 3 certifying the date of filing. In addition, the appropriate block in Item I.D. should be checked to indicate that a U.S. claim has been filed.
When a Luxembourg agency certifies factors of entitlement as "verified" in Part II of the form LUX/USA 3, the certification may be accepted as proof of the eligibility factor. Further development is not required unless there is a material discrepancy.
Use this instruction for processing form LUX/USA 3 if:
the block is checked in item I.D to indicate the claimant is filing a U.S. claim, or
a statement of intent to file a U.S. claim is attached.
1
Provide information and/or material that the Luxembourg agency requested on the form LUX/USA 3.
2
Determine if the claimant is eligible for U.S. benefits.
If yes, route all material to CDB to develop a claim.
If no, go to step 3.
3
If the claimant is not eligible or is already entitled to U.S. benefits, send an informal denial notice.
Use this instruction for developing claims filed with a Luxembourg agency.
fully insured
obtain the appropriate RSDI application,
obtain evidence to establish factors of entitlement that were not established by the Luxembourg agency,
adjudicate the RSDI applications, and
forward the claim to Mods 1-5.
not insured and has at least 6 QCs
obtain the appropriate RSDI application and form SSA-2490-F4,
obtain evidence to establish factors of entitlement not established by the Luxembourg agency, adjudicate RSDI application, and forward the claim to Mod 6 or 7.