To secure medical examinations for the Uruguayan liaison agency, use the following
process:
1. The Uruguayan Liaison Agency request for medical examinations
The Uruguayan liaison agency requests medical examinations using Form SSA 2960 USA/UY
3 (U.S. - Uruguay Agreement on the Social Security Transmittal/Request/Certification).
2. SSA schedules an examination or forwards pertinent medical evidence
SSA schedules an examination or forwards copies of “pertinent medical evidence” from
SSA files to the Uruguayan 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 Uruguayan liaison
agency has specifically requested medical evidence. SSA’s files include a paper claims
folder and electronic files.
3. SSA requests reimbursement for cost of medical examinations
SSA requests reimbursements for the cost of medical examinations obtained for the
Uruguayan liaison agency using form SSA-1278 USA/UY 9 Request for Payments of Reimbursable
Expenses under U.S. - Uruguay Agreement on Social Security. Once the form is completed,
scan it into electronic file (CFUI) and send a copy to:
Address:
Banco de Prevision Social
Colonia 1881 Piso 2
C.P. 11200
Montevideo, Uruguay
You can print this form from the SSA Totalization Forms section of the Division of
International Operations “Totalization Resource Kit.”