TN 3 (02-95)
After the foreign coverage record is received, the CS determines if the NH is insured based on combined U.S. and foreign coverage. See the specific agreement subchapter for rules on crediting foreign coverage.
Follow the steps below once the insured status decision is made.
Proceed as follows if totalization insured status is met.
Develop for any evidence still missing.
If the claim is for disability benefits, send the medical jacket to IDU for a disability determination. Be sure to show the date insured status is last met on the SSA-559 (Claims Folder Material Transmittal).
If all other factors of entitlement are met, prepare a totalization award using the guidelines in MS MCS 014.001. Designate the appropriate paragraphs (See NL 00711.305).
Send the file to a BA for processing through MADCAP.
See GN 01703.310 if you must deny the claim for a reason other than lack of insured status; e.g., not disabled, relationship not established, etc.
If required by the individual country, send the file to the BET to prepare a final package informing the foreign agency of our decision. (See individual DIO agreement subchapters to determine if a final package is required.)
If totalization insured status is not met:
Deny the claim using the guidelines in GN 01703.310.