TN 7 (06-04)
An individual who wishes to file for U.S. Totalization benefits under the agreement with Canada must complete the appropriate modernized claim system (MCS) application screens as well as the SSA-2490 screens. If the SSA-2490 cannot be completed on MCS (GN 01715.215B.), the individual must complete Part I only of either a paper or electronic (e-form) SSA-2490-BK (Application For Benefits Under A U.S. International Social Security Agreement).
An individual who wishes to file for U.S. Totalization benefits and Canadian benefits must complete the appropriate MCS application screens (including the SSA-2490 screens) and one or both of the special Canadian application forms discussed in GN 01715.220. If the SSA-2490 cannot be completed on MCS (GN 01715.215B.), the individual must complete Part I only of either a paper or electronic (e-form) SSA-2490-BK.
An individual who wishes to file only for Canadian benefits must complete one or both of the special Canadian application forms discussed in GN 01715.220 but does not need to complete Form SSA-2490-BK.
NOTE: When an applicant is filing for regular (nontotalization) benefits from the U.S. and benefits from Canada (regular or Totalization), it is not necessary to complete the SSA-2490. However, MCS will not allow clearance of the claim for U.S. benefits until the path for the SSA-2490 is entered. To clear the U.S. claim, complete only the first (FINF) screen in the SSA-2490 path. This will release the claim for U.S. benefits for award or denial. The claim for Canadian benefits should then be completed using the appropriate Canadian application forms described in GN 01715.220.
The SSA-2490-BK is available through MCS, but the MCS version may only be used when the number holder (NH) is filing for:
U.S. retirement or disability Totalization benefits only, or
U.S. retirement or disability benefits (regular or Totalization) and concurrently for Canadian benefits.
The MCS version of the SSA-2490-BK may not be used to file for:
Canadian benefits only, or
U.S. survivors Totalization benefits or Canadian survivors benefits.
A paper or electronic (e-form) SSA-2490-BK application form must be used to file for U.S. survivors benefits under the agreement. Form SSA-2490-BK is also available through the Totalization Benefits Resource Kit on the Intranet here.
NOTE: It is not necessary to take an SSA-2490-BK in claims for U.S. auxiliary benefits in life cases or in survivor cases where there was a previously approved award in a life case since this application would have been completed previously in connection with the NH's claim.
Use the following information to determine which applications must be completed when taking claims for U.S. Totalization benefits under the agreement with Canada:
In retirement or disability claims, complete the appropriate retirement or disability benefit MCS application screens, the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011 ), and the SSA-2490 screens (see MSOM MCS 007.001 ).
In survivors claims, complete the appropriate MCS application screens, the TOTALIZATION (TOTL) screen (see MSOM MCS 009.011 ), and Part I of the paper or electronic (e-form) application Form SSA-2490-BK.
NOTE: Form SSA-2490-BK is available through the Totalization Benefits Resource Kit on the Intranet here.
Completing forms for Canadian benefits, GN 01715.220
Completing the SSA-2490 on MCS, MSOM MCS 007.001
Totalization (TOTL) screen, MSOM MCS 009.011
Completing the paper or electronic (e-form) Form SSA-2490-BK, GN 01702.110
Forwarding application to the Office of International Operations, GN 01702.310
Processing notices in claims for U.S. Totalization benefits, GN 01702.315