Whenever an applicant alleges on an application for U.S. benefits that the number holder (NH) has coverage in a country with which the United States has a Totalization agreement, you should route the claim to the Office of Earnings and International Operations (OEIO) if there is a possibility of entitlement to Totalization benefits or the program service center (PSC) of jurisdiction if there is no possibility of entitlement to Totalization benefits. Section GN 01702.410 provides the routing procedures for claims for U.S. Totalization disability benefits.

If entitlement to a Totalization benefit is possible, either because the NH has at least 6 QCs but is not insured based on U.S. coverage alone or Totalization could establish an earlier month of entitlement, forward the claim to:

Print “TOTALIZATION CLAIM” on the route slip transmitting the folder. If the claim is being forwarded to OEIO only because Totalization could establish an earlier month of entitlement, suppress the notice described in GN 01702.315A.

If entitlement to a Totalization benefit is not possible either because the NH has less than 6 QCs or Totalization could not establish an earlier month of entitlement, forward the claim to the appropriate PSC of jurisdiction.

Upon receipt of a claim with possible entitlement to a Totalization benefit, OEIO will request the foreign earnings record. If the NH is insured based on U.S. QCs but Totalization could establish an earlier month of entitlement, OEIO will delete the language from the award notice that says Totalization is not possible because the NH is insured without the foreign coverage. When OEIO receives the foreign coverage record, it will convert the foreign credits to QCs, adjudicate the claim and generate an award or disallowance notice, as appropriate.

Routing of claims for U.S. Totalization disability benefits, GN 01702.410