Effective Dates: 02/02/2023 - Present Previous | Next

TN 3 (02-23)

GN 01743.215 Application for Benefits under the U.S. - Australian Agreement

A. Filing for benefits using multiple application forms

 

1. Totalization benefits only - Form SSA-2490-BK

When an applicant files for U.S. Totalization benefits under the U.S. - Australian Agreement, the field office (FO) must complete Part I of Form SSA-2490-BK (Application For Benefits Under A U.S. International Social Security Agreement) using the appropriate Modernized Claim System (MCS) screens. The FO must also complete the appropriate retirement, survivors, or disability insurance application(s).

2. U.S. Totalization and Australian benefits - Special Australian applications forms

An individual who wishes to file for both U.S. Totalization benefits and Australian benefits must complete Part I of Form SSA-2490-BK, the appropriate retirement, survivors or disability insurance application(s) and the following special Australian forms.

  • •

    Application (AUS140-US(A).0210 Part B - Australian Pension Claim)

  • •

    Form Mod(i) (CIS- U.S.0210)

  • •

    Work Ability Form (AUS142-UU.0210 - for disability applications only)

  • •

    SSA- 1278 Request for Payment of Reimbursable Expenses under the U.S.A. - Australia Agreement on Social Security

You can access these special Australian forms in the Totalization Benefits Resource Kit online.

NOTE: 

When an applicant is filing for regular (non-Totalization) benefits from the U.S. and benefits from Australia (regular or Totalization), it is not necessary to complete the SSA-2490. However, the Modernized Claims System (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 Australian benefits should then be completed using the Australian forms described in GN 01743.220.

B. Using the MCS version of Form SSA-2490-BK

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.

1. When to use the MCS version

Form SSA-2490-BK is available through MCS. Use the MCS version only 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 Australian benefits.

2. When not to use the MCS version

Do not use the MCS version of Form SSA-2490-BK when the applicant is filing for :

  • •

    Australian benefits only, or

  • •

    U.S. or Canadian survivors benefits.

Use the paper or electronic Form SSA-2490-BK for Totalization survivor claims. For instructions on how to complete the SSA-2490-BK, see GN 01702.110.

If there is an existing U.S. Totalization life claim award, do not take an SSA-2490-BK in claims for U.S. auxiliary benefits or survivor claims.

C. Determining the required application screens on MCS for Totalization benefits

Use the following information to determine which application screens to complete when taking claims for U.S. Totalization benefits under the agreement with Australia.

1. Retirement or disability claims

In retirement or disability claims, complete the appropriate retirement or disability benefit MCS application screens, the TOTALIZATION (TOTL) screen (see MS 03509.011), and the SSA-2490 screens (see MS 03507.001).

2. Survivors claims

In survivors claims, complete the appropriate MCS application screens, the TOTALIZATION (TOTL) screen (see MS 03509.011), and Part I of the paper or electronic Form SSA-2490-BK.

D. Applications for Australian benefits

All applicants for Australian benefits must complete a special application form (Form AUS140–US(A).0210). This form has two parts. Part A contains instructions for completing the form and Part B is the actual application. Since Australian benefits are income/resource tested, all applicants must also complete Form Mod (i) listing their income and assets. In addition, applicants for Australian disability benefits must also complete a Work Ability-Customer Information form (Form WA) showing how their disabilities impact their daily activities.

When applicants submit special application forms for Australian benefit, the FO should:

  1. 1. 

    Access the Totalization Benefits Resource Kit.

  2. 2. 

    Print Part A and B of the Australian application form (Form AUS140–US(A).0210) and income and assets form (Form Mod i) and give them to the applicant for completion.

  3. 3. 

    If the applicant is filing for disability benefits, also print the Work Ability form (Form WA) and give it to the applicant for completion.

  4. 4. 

    Provide any necessary assistance in completing the Australian forms.

  5. 5. 

    Photocopy and certify any documents (evidence) submitted by the applicant.

  6. 6. 

    Send the claim (with certified copies) to OIO in Baltimore at the address shown in GN 01702.310.

Once OIO receives the claim, OIO will send the claim directly to the Australian agency along with a copy of the applicant's U.S. coverage record.

 

E. References

  • •

    MS 03507.001, Introduction to SSA-2490 - Overview

  • •

    MS 03509.011 Totalization (TOTL)

  • •

    GN 01702.110 Application for Benefits under a U.S. International Social Security (Totalization) Agreement (Form SSA-2490-BK)

  • •

    GN 01702.310 Routing of Claims for U.S. Benefits Involving Totalization

  • •

    GN 01702.315 Processing Totalization Insured - Status Notices in Claims for U.S. Benefits

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201743215
GN 01743.215 - Application for Benefits under the U.S. - Australian Agreement - 02/02/2023
Batch run: 02/02/2023
Rev:02/02/2023