Letters

Revised March 25, 2011

Purpose: The department of social and health services (DSHS) sends you letters to tell you about your case.

100 Series Reason Code Protocols

Revised January 21, 2020

Purpose:

100 Series Reason Code Protocols
Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.
For ACES Procedures go to ACES Letters in the ACES User Manual.
Staff must add explanatory text to the notice unless the "Recommended Free Form Text" column specifies "None Required."
The "Recommended Free Form Text" is the suggested wording for a reason code requiring mandatory explanation to the client.

Code	Reason Code Title / Text	WAC References	Recommended Free Form Text
101	ABD Cash/HEN Referral Spouse Ineligible You can't receive Aged, Blind, or Disabled (ABD) cash or a Housing and Essential Needs (HEN) Referral when your spouse receives Supplemental Security Income (SSI) and a State Supplemental Payment (SSP).	182-508-0005 388-400-0060 388-400-0070 388-474-0010 388-474-0001 388-474-0012	None Required
102	WASHCAP Application Month Denied - For Administrative Use Only	None	None Required
103	WASHCAP Terminates - Client Has Had Earned Income For More Than Three Months You can't receive Washington State Combined Application Project (WASHCAP) food assistance because you've been working more than 3 months.	388-492-0030	None Required
104	SSA Terminates WASHCAP Food Assistance Social Security asked us to stop your Washington State Combined Application Project (WASHCAP) food benefits. See WAC rule (Washington Administrative Code)	388-492-0110 388-492-0030 388-492-0120	None Required
105	WASHCAP Terminates - Client Living Situation Has Changed You can't receive Washington State Combined Application Project (WASHCAP) food benefits because your living arrangement changed.	388-492-0030	None Required
106	WASHCAP Terminates - Client Getting $1.00 Or Less SSI Money You stopped receiving SSI cash.	388-492-0030	None Required
107	WASHCAP Terminates - Client Not Eligible For SSI Money Or Medical SSA decided that you cannot get SSI. See WAC rule (Washington Administrative Code):	388-492-0030 388-492-0120	None Required
109	Not SSP Eligible - Client's SSI Terminated You can't receive a State Supplemental Payment if you’re not receiving a Supplemental Security Income (SSI) payment.	388-474-0012	None Required
110	Not SSP Eligible - Invalid Living Arrangement You can't receive a State Supplemental Payment (SSP) when you live in an institution.	388-474-001 2	None Required
111	Not SSP Eligible - SSI Eligibility Category Change You can only receive a State Supplemental Payment (SSP) if you receive SSI and one of the following is true: You live with your SSI ineligible spouse. You are blind. You are age 65 or older.	388-474-0012	None Required
112	Receiving Tribal TANF Benefits We believe you are eligible for cash benefits from the tribe	388-400-0005	If you are a client in a household which is eligible for a tribal TANF program, you cannot receive state and tribal TANF in the same month.
120	Failed to Provide Proof of Citizenship/Identity You did not provide proof of citizenship for a member or members of your household. Proof of citizenship is required before a person can receive medical.	388-490-0005 182-503-0535	Specify the persons who are ineligible due to lack of proof of citizenship
121	Ineligible Spouse of an SSI Recipient – Medical Because your spouse receives SSI, you aren’t eligible for Community First Choice services.	182-512-0100	No Mandatory Freeform Text
130	Not TFA Eligible – Not Recipient of BF in Prior Month The people listed above won't receive Transitional Food benefits with you because they didn't receive Basic Food benefits with you during the last month you received cash assistance.	388-408-0035 388-489-0005	None Required
131	A Member of the Household is now receiving TANF Someone who gets Transitional Food with you is approved for Temporary Assistance for Needy Families (TANF) or Tribal TANF. We will see if you can get Basic Food. You may need to turn in an eligibility review for us to see if you can get Basic Food.	388-489-0025	Specify the person who is receiving TANF or Tribal TANF.
132	RCA E&T Participation Refugee Cash Assistance requires participation in an employment and training program.	388-466-0120 388-466-0150	None required
133	One Caretaker Relative Recipient Only one caretaker (non-parent) can be recipient on a TANF or SFA grant.	388-408-0025	None required
134	No WF Orientation The person(s) listed below didn't attend the required WorkFirst Orientation.	388-400-0005 388-400-0010	None required
141	Mid-Certification Review Not Returned We did not get your mid-certification report form. If you get us what we need before the end of the month, we will reconsider our decision. You must either: · Turn in the form; or · Call us to report your current circumstances.	388-418-0011	None Required
142	Incomplete Mid-Certification Review We got your mid-certification report form. Some information is still missing. We sent you a letter telling you what you need to give to us. We did not get it.	388-418-0011	List the missing items.
160	MCS Enrollment Cap We aren't currently enrolling new members in this program. This medical program isn't accepting new enrollees because of an enrollment cap due to limited funding.	182-508-0150	None required
161	MCS Enrollment Cap - Client Placed on Wait List We aren't currently enrolling new members in this program. This medical program isn't accepting new enrollees because of limited funding. We added you to the waiting list. Those on the waiting list longest will receive the first opportunity to apply. We'll notify you by mail when space is available.	182-508-0150	None required
162	MCS Enrollment Cap - Already on Wait List We aren't currently enrolling new members in this program. You are already on the medical coverage waiting list.	182-508-0150	None required
163	Medical Care Services (MCS) is only available for recipients of the AGed, Blind, Disabled, (ABD) cash program, or the Housing and Essential Needs (HEN) Referral program. The household member(s) listed won't be eligible for assistance from these programs.	182-508-0150	None required
164	You entered the U.S. on or after August 22, 1996 and were eligible for limited health care coverage. You have been here legally for 5 years. Your health care coverage is ending. You may be eligible for new health care coverage under the Affordable Care Act. To find out go to www.wahealthplanfinder.org or call 1-855-923-4633. This change does not affect your HEN eligibility.	182-503-0535 182-508-0001 182-508-0005 388-400-0060 388-400-0070 388-424-0015	None required
167	TSOA - Invalid Waiver You need an approved plan before we can help you and your caregiver	182-513-1610	No Mandatory Freeform Text
168	TSOA – Client Active in a Different AU You can’t receive services under this program when you are eligible for certain Medicaid programs.	182-513-1615	No Mandatory Freeform Text
177	Missed Food Application Deadline We must make a decision on your eligibility within 30 days from the date you applied. We don’t have enough information to determine your eligibility. We’ve denied your application.	388-406-0035 388-406-0040	None required.
187	Client Already Received CN Medicaid In Another AU For This Benefit Month - For Administrative Use Only	None	None Required
188	Medical Review Not Completed Your medical disability review was not completed in time. This is because: We did not get updated medical information; or We got your medical information but it is still being reviewed.	182-512-0050	Specify person who is being terminated.
195	Failed Blind or Disabled Requirements - HWD You don't meet federal blind or disability requirements based on the medical evidence we have.	182-511-1050 182-511-1150	None required

200 Series Reason Code Protocols

Revised on: November 29, 2022

Purpose:

200 Series Reason Code Protocols
Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.
For ACES Procedures go to ACES Letters in the ACES User Manual.
Staff must add explanatory text to the notice unless the "Recommended Free Form Text" column specifies "None Required."
The "Recommended Free Form Text" is the suggested wording for a reason code requiring mandatory explanation to the client.

Code	Reason Code Title / Text	WAC References	Recommended Free Form Text
200	Non-Citizen Medicaid Ineligibility You do not meet the citizenship or alien status requirements to receive Washington Apple Health.	182-503-0505 182-503-0535	Need to specify which persons in AU do not meet citizenship requirements.
201	Living Arrangement - Cash / Medical Assistance Due to your living arrangement, we do not consider you a member of the household.	388-408-0015 388-408-0020 388-408-0025 388-408-0060 388-408-0070 182-506-0010 182-506-0015	Your living arrangement does not meet our requirements because (specify relevant requirement and how client's living situation does not meet that requirement) . (Note to Users: This reason code is based on the valid value entered in the living arrangement field on the DEM1 screen).
202	Citizenship / Alien Status Immigrant requirements have not been met to receive these benefits.	388-400-0070 388-424-0010 388-424-0015 388-424-0020 182-503-0505 182-503-0535 182-505-0115 182-505-0210 182-505-0240 182-505-0250 182-508-0001	If client submitted verification of alien status: You do not meet the requirements because (specify relevant requirement and how client's alien status does not meet that requirement). . If client didn't submit verification of status: We can't determine if you meet our requirements because we do not have verification of your citizenship status.
203	Receiving SSI People who receive Supplemental Security Income (SSI) can't receive DSHS cash benefits for themselves or a Housing and Essential Needs (HEN) Referral.	388-408-0020 388-400-0060 388-400-007 0 388-474-0020	None Required
204	No Dependent Child You aren't pregnant and don't have a dependent child living with you. You will receive another letter if you can receive health care coverage from another program. See WAC rule (Washington Administrative Code):	182-505-0240	If pending medical: We have not figured out if you are eligible for medical assistance because we are still waiting to hear if your condition meets our definition of a disability or emergency medical condition.
205	Failed Age / School Attendance Children over 18 years old must meet certain requirements to get these benefits. Your child does not meet these requirements. See WAC rule (Washington Administrative Code):	388-404-0005	(Name) is # years old. S/he cannot get assistance because (specify requirement that client does not meet). .
206	Living Arrangement - Food Assistance Due to your current living arrangement, we do not consider you a member of the household. See WAC rule (Washington Administrative Code):	388-408-0035 388-408-0040 388-492-0030	Your living arrangement does not meet our requirements because (specify requirement that client does not meet) . (Note to Users: This reason code is based on the valid value entered in the living arrangement field on the DEM1 screen).
207	Failed Eligible Student Requirement - Food Assistance Students have to meet certain requirements to get benefits. You do not meet the requirements. See WAC rule (Washington Administrative Code):	388-482-0005	Specify requirements and why client doesn't meet them.
208	Failed Social Security Number (SSN) Requirement We don't have one of the following: A valid Social Security Number (SSN) Proof of a recent application for a SSN	182-505-0115 182-508-0001 388-476-0005 182-503-0505 182-503-0515	Need to specify which person(s) in AU we require the SSN for.
209	Failed Refugee Requirement Refugees and asylees must meet certain requirements to get benefits from this program. You do not meet the requirements. See WAC rule (Washington Administrative Code):	388-400-0030 388-466-0005 182-507-0130 182-507-0135	For refugees: You entered the United States on 00/00/00. (Specify why this doesn't meet the requirements.) or For asylees: You were granted asylee status on 00/00/00. (Specify why this doesn't meet the requirement.)

Code	Reason Code Title / Text	WAC References	Free Form Text
210	Failed Residency Requirement We don’t consider you a resident of Washington.	388-400-0005 388-400-0040 388-400-0060 388-400-0070 388-454-0015 388-468-0005 182-503-0505 182-503-0520 182-503-0525	You do not meet the residency requirements because (specify client facts showing why client is not considered a WA resident) .
212	No Relationship To receive cash assistance for a child, you must be: A relative, A legal guardian, Acting as the child's parent, or A court ordered custodian. See WAC rule (Washington Administrative Code):	388-454-0005 388-454-0010	(Caretaker's name) is not a relative of specified degree, legal guardian, acting as a parent or permanent custodian of (Child's Name). (Note to Users: This reason code is based on the valid value entered in the relationship field on the STAT screen). If pending medical: We have not figured out if you are eligible for medical assistance because we are still waiting to hear if your medical condition meets our definition of a disability or emergency.
213	Failed Pregnancy Requirement - S Medical & Family Planning Medical You cannot get benefits until we have proof that you are pregnant or have been pregnant in the last 12 months. See WAC rule (Washington Administrative Code):	388-462-0010 388-408-0015	You are not eligible for post-partum coverage because it has been more than 2 months since your pregnancy ended. or You are not eligible for family planning coverage since it has been more than 12 months since your pregnancy ended.
214	TANF Pregnancy Only - Father of Unborn Not Eligible Only a pregnant woman can get TANF/SFA when there are no other children in the household. Until the baby is born, the father of your unborn child cannot get TANF/SFA. SeeWAC rule (Washington Administrative Code):	388-408-0015	None Required
215	Failed Work Registration Requirements You are required to participate in the Employment and Training program. You have not met the registration requirements or given us proof that you have good cause not to participate. See WAC rule (Washington Administrative Code):	388-444-0015 388-444-0005 388-444-0050	You did not on 00/00/00. You cannot get benefits from 00/00/00 to 00/00/00 unless you . If you don't do this, you will have to reapply after 00/00/00 and start participating.
218	Roomer - Food Assistance The person listed above is a roomer. A roomer is someone who pays for rent and not for meals. Roomers must apply for food assistance on their own. See WAC rule (Washington Administrative Code):	388-408-0035	None Required
219	Voluntary Quit We do not have proof that you had good cause to quit your job. SeeWAC rule (Washington Administrative Code):	388-444-0060 388-444-0065 388-444-0070 388-444-0075	You quit your job or reduced your work effort at on 00/00/00. You cannot get benefits until [disqualification period] unless you become exempt from work registration. If you want benefits, you must reapply. You can get food assistance, during this time if you become exempt from work registration.

Code	Reason Code Title / Text	WAC References	Free Form Text
220	Failed Age Requirement - Medical You don’t meet the age requirement for this program. See WAC rule (Washington Administrative Code):	182-505-0210 182-505-0211 182-508-0001	You must be to get benefits from this program.
221	Failed Incapacity Requirement We do not have proof that your condition keeps you from working for at least 90 days.	388-447-0001	During your financial interview on 00/00/0000, you did not report an incapacity. If a 14-118 (IND) is received, use the mandatory free form text included in the 14-118.
222	Eligibility Not Established For Month We could not approve your benefits for the months listed because we did not get your information in time. You will get another letter listing the months that you can get benefits. See WACrule (Washington Administrative Code):	182-513-1315 182-515-1505 182-515-1510 388-406-0055 388-406-0056	None Required
223	Failed E&T Requirements - 2nd Offense You are required to participate in the Employment and Training program. You have not met the registration requirements or given us proof that you have good cause not to participate. Since this is your second offense, you may not get food assistance for 3 months and until you participate. See WAC rule (Washington Administrative Code):	388-444-0050 388-444-0005 388-444-0055 388-444-0010	You did not on 00/00/00. You cannot get benefits until 00/00/00. If you want food assistance after that, you must reapply and start participating.
224	Failed E&T Requirements - 3rd Offense You are required to participate in the Employment and Training program. You haven’t met the registration requirements or given us proof that you have good cause not to participate. Since this is your third offense, you may not receive food assistance for <6> months and until you participate. See WAC rule (Washington Administrative Code):	388-444-0050 388-444-0005 388-444-0010 388-444-0055	You did not on 00/00/00. You cannot get benefits until 00/00/00. If you want food assistance after that, you must reapply and start participating.
225	Now Receiving SSI When you get SSI (Supplemental Security Income) you also get medical benefits from DSHS. You will get a letter telling you about SSI Medical. If you have questions, please call 1-800-562-3022. See WAC rule (Washington Administrative Code):	182-510-0005	None Required
226	Residing In Inpatient Psychiatric Institution We can’t give you cash assistance while you are living in an inpatient psychiatric institution. See WAC rule (Washington Administrative Code):	388-400-0060 388-400-0070 388-400-0005	None Required
227	Under Previous Work Registration Penalty - Food Assistance You have a penalty period because you did not participate in the Employment and Training program. We cannot give you food assistance until the penalty period is over, you reapply and you participate. See WACrule (Washington Administrative Code):	388-444-0055 388-444-0050 388-444-0005 388-444-0010	You cannot get benefits until 00/00/00. We told you about this on 00/00/00.
228	IV-D Non-Cooperation You have not helped DCS (Division of Child Support) get support for a child you get benefits for. You don't have to help DCS if you prove you have good cause because it would put you or a child in danger. If you swear under oath that you have given DCS all the information you have, you will keep getting medical benefits. Contact your DCS worker for more information.See WAC rule (Washington Administrative Code):	388-422-0005 388-422-0010 388-422-0020 388-14A-2040 388-14A-2041 388-14A-2045 388-14A-2050 388-14A-2060 388-14A-2075	DCS told us that you (specify non-cooperation) .
229	Exceeds Adult Recipient TANF Time Limits An adult or emancipated minor in your assistance unit received 60 months of TANF/SFA cash assistance and doesn't qualify for a time limit hardship extension.	388-484-0005 388-484-0006 388-484-0010	None Required

Code	Reason Code Title / Text	WAC References	Free Form Text
230	Verification You did not give us the information we asked for. We can't figure out if you are eligible without it.	388-472-0005 388-490-0005 388-400-0070	On 00/00/00, I asked you to provide the following items by 00/00/00: List of items
232	IPV Disqualified A judge or hearing officer found that you broke a food assistance rule on purpose. You will get another letter with information about your penalty. See WAC rule (Washington Administrative Code):	388-446-0020 388-446-0015	This is the (first/second/third) time that (name) has done this. S/he cannot get benefits again until 00/00/00.
233	Change In Household Size The number of people getting assistance with you has changed. See WAC rule (Washington Administrative Code):	388-400-0060 388-400-0070 388-408-0025 388-408-0030 388-408-0035 388-408-0015 388-408-0020	(Name) moved in/out on 00/00/00. or (Name) is now/no longer getting benefits with you because.
235	Review Not Complete We did not get your review form. If we get it before the end of the month, we will reconsider our decision. If you have already sent it, let me know. See WAC rule (Washington Administrative Code):	182-504-0035 388-434-0005 388-434-0010 388-492-0110 388-492-0100 388-492-0090 388-400-0070	None Required
237	Change In Shelter Cost / Shelter Deduction There was a change in the amount you pay for housing and utilities. See WAC rule (Washington Administrative Code):	388-450-0195 388-478-0020 388-478-0027 388-478-0090 388-492-0070 388-450-0190 388-478-0033 388-478-0035	For cash assistance: You are no longer living in a facility or institution. or You now have your housing needs addressed by a facility or institution. For food assistance: Your____changed from $ to $ .
238	Change In Food Assistance Medical Expenses Your medical expenses have changed. See WAC rule (Washington Administrative Code):	388-450-0200	If newly elderly/disabled: Since you are now considered disabled or elderly we are using your medical expenses to figure out how much of your income counts.

Code	Reason Code Title / Text	WAC References	Free Form Text
240	CEAP AUTO Close - For Administrative Use Only	None	None Required
242	Prior Lump Sum Penalty Period Exists You cannot get assistance because of your lump sum payment. See WAC rule (Washington Administrative Code):	388-450-0245 388-470-0005 182-509-0220	You got $ from on 00/00/00. You cannot get benefits until 00/00/00. We told you about this on 00/00/00.
244	Death We were notified someone passed away. Please accept our condolences for your loss.	182-503-0505 388-408-0005 388-408-0035 388-492-0030 388-489-0025	Specify the person who died.
245	No Eligible Household Members No one in your household meets the requirements to get assistance. See WAC rule (Washington Administrative Code):	388-400-0070 388-408-0005 388-408-0015 388-408-0020 388-408-0025 388-408-0035 388-408-0060 388-408-0070 388-492-0030	If no other reason code or letter: No one is eligible because (specify the requirement if not met. If more than one specify the one that applies to all members or the one that primarily prevented eligibility) .
246	Under Previous Penalty Your penalty period is not yet over. Ask your worker what to do to get out of sanction. See WAC rule (Washington Administrative Code):	388-444-0055 182-505-0240	You cannot get benefits because (specify what action caused the penalty). . We told you about this on 00/00/00. You cannot get benefits until 00/00/00.
247	Under Previous Non-Cooperation With QC Penalty Your penalty period is not yet over. Ask your worker what to do to get out of sanction. See WAC rule (Washington Administrative Code):	388-464-0001	You cannot get benefits for # months because (specify what action caused the penalty) . You can regain your eligibility by (specify actions needed to be eligible again . If you have any questions about this, call the Quality Assurance worker at (000) 000-0000.
248	Head of Household Not Eligible You aren't eligible for assistance. See WAC rule (Washington Administrative Code):	388-408-0035 388-468-0005 388-492-0030	(Name) cannot get benefits because (specify why that person cannot get benefits - requirement not met and why they don't meet it).
249	Receipt Of Benefits From Another State During Month Your assistance unit already got benefits from another state this month. You canâ€™t get assistance from Washington and another state in the same month. Please contact your worker if you and your children have an emergency. See WAC rule (Washington Administrative Code):	388-468-0005 388-400-0070 182-503-0505 182-505-0210 182-505-0240 182-508-0001	You already got benefits from (Name of State).

Code	Reason Code Title / Text	WAC References	Free Form Text
250	Not Aged, Blind Or Disabled - Medical You cannot get medical benefits under this program because you do not meet the rules set by the Social Security Administration (SSA). The rules say you must be age 65 or older, blind, or disabled. See WAC rule (Washington Administrative Code):	182-508-0001	None Required
251	Already Received Food Assistance You already got food assistance this month. You cannot get more unless you just moved to a shelter for battered women and children. See WAC rule (Washington Administrative Code):	388-468-0005 388-408-0045	None Required
252	Non-Compliance Sanction for not participating in the WorkFirst program as required See WAC rule (Washington Administrative Code):	388-310-1600	(Name) is in non-compliance sanction status.
254	Under Previous Transfer Of Resources Penalty - Food Assistance Your assistance unit sold or gave away property for less than it was worth. See WAC rule (Washington Administrative Code):	388-488-0010	You transferred your (type of property) on 00/00/00. Since you did not get the fair market value, you cannot get benefits from 00/00/00 to 00/00/00. We told you about this on 00/00/00.
255	Transfer Penalty Still In Effect (MA) Your penalty period for transferring money or property has not ended. Your penalty cannot be stopped unless you prove that you cannot pay for your housing, food, clothing, or health needs. See WAC rule (Washington Administrative Code):	182-513-1363 182-513-1364 182-513-1365 182-513-1366 388-488-0005 388-488-0010	You transferred your (type of property) on 00/00/00. Since you did not get the fair market value, you cannot get benefits from 00/00/00 to 00/00/00. We told you about this on 00/00/00.
256	Fleeing Felon & Parole Violation - CA / FA Our rules say that no one fleeing or breaking parole/probation to avoid going to court or jail for a felony charge can get cash or food assistance. See WAC rule (Washington Administrative Code):	388-442-0010 388-492-0120	Specify the information used to verify that A/R was fleeing or breaking probation/parole, and what the violation is. A finding that the A/R is breaking probation or parole must be from an administrative body or court.
258	Failed ABAWD Requirement You are an Able Bodied Adult Without any Dependents (ABAWD) who did not work or participate in a work or training program. You already got food assistance for three months in this 36-month period and cannot have more now. See WAC rule (Washington Administrative Code):	388-444-0030 388-444-0035 388-444-0045	None required.
259	Temporary Absence Change Not Reported In 5 Days Your child is out of your home for more than 180 days. You did not tell us about this within 5 days of when you knew they'd be gone this long. As a penalty, you will not get your part of the grant for 1 month.	388-418-0007	(Name of child(ren)) left your house on (date). You knew they were going to be gone for longer than 90 days because (specify information source and how recipient knew this).

Code	Reason Code Title / Text	WAC References	Free Form Text
260	Food Assistance Voluntary Quit - 2nd Offense We do not have proof you had good cause to quit your job. Because this is the second time you quit a job without good cause, you cannot get food assistance for 3 months. After that, you must reapply and comply with the work requirements to get food assistance again. See WAC rule (Washington Administrative Code):	388-444-0065 388-444-0075 388-444-0070	You quit your job at on 00/00/00. You cannot get benefits until 00/00/00 unless you reapply and (specify what client has to do to get benefits before that).
261	Food Assistance Voluntary Quit - 3rd Or Subsequent Offense We do not have proof you had good cause to quit your job. Because this is the third time that you quit a job without good cause, you cannot get food assistance for 6 months. After that, you must reapply and comply with the work requirements to get food assistance again. See WAC rule (Washington Administrative Code):	388-444-0065 388-444-0075 388-444-0070	You quit your job at on 00/00/00. You cannot get benefits until 00/00/00 unless you reapply and (specify what client has to do to get benefits before that)..
262	Convicted of Receiving PA In 2 Or More States We cannot give you cash assistance because you were convicted of fraud. You got benefits from more than one state at the same time. The only people with such a conviction that can get cash assistance are pregnant women. See WAC rule (Washington Administrative Code):	388-446-0010	Specify which other state the benefits were received in and when they were received.
263	Convicted Of Unlawful Practices You cannot get cash assistance right now because a court decided that you broke the law to get cash assistance. See WAC rule (Washington Administrative Code):	388-446-0005 388-446-0010 388-400-0070	You were convicted on 00/00/00. The court says you cannot get benefits until 00/00/00.
264	Minor Parent Inappropriate Living Situation We did not approve your living arrangement. Unmarried parents who are younger than age 18 must have their living arrangement approved by the department unless they live with their parent, legal guardian or other adult relative. See WACrule (Washington Administrative Code):	388-486-0005	None Required
265	Minor Parent Failed School Requirement To get assistance, you must be in high school or in another program approved by the department. See WAC rule (Washington Administrative Code):	388-486-0010	None Required
266	Non-Cooperation With TPL We did not get your form about other coverage for your medical bills. You cannot get medical benefits from DSHS until we have the information. Your children can still get medical assistance. See WAC rule (Washington Administrative Code):	182-503-0540	None Required
268	40% WorkFirst Sanction You are not getting your part of the grant because you did not follow the rules about your IRP (Individual Responsibility Plan). You are in WorkFirst sanction. There are penalties for being in sanction See WAC rule (Washington Administrative Code):	388-310-1600	(Name) did not (specify IRPrequirement not met) on 00/00/00. We told you about this on 00/00/00. (Name) can regain eligibility by .
269	10-Year Penalty For Fraudulent Statement You are not eligible for food assistance because you have been convicted of providing false identification or residency information. This kind of conviction disqualifies you for ten years. See WACrule (Washington Administrative Code):	388-446-0020	You were convicted on 00/00/00.

Code	Reason Code Title / Text	WAC References	Free Form Text
271	Trafficking Less Than $500 Or For Controlled Substance You were convicted of trading food assistance for a controlled substance. See WAC rule (Washington Administrative Code):	388-446-0020 388-492-0120	You cannot get benefits from 00/00/00 to 00/00/00 because you .
272	Permanent Disqualification - Illegal Trafficking More Than $500 Or For Controlled Substance You are permanently disqualified from getting food assistance because you were: Convicted of trading food assistance for a total of $500 or more; Convicted twice of trading food assistance for a controlled substance; Convicted of trading food assistance for firearms, ammunition, or explosives; or See WAC rule (Washington Administrative Code):	388-446-0020 388-492-0120	You cannot get benefits from 00/00/00 to 00/00/00 because you .
275	No Longer Receiving SSI You no longer get SSI (Supplemental Security Income).	182-510-0005 388-492-0030	None Required
276	Your medical condition doesn’t meet the emergency medical requirements for Washington Apple Health Alien Emergency Medical Coverage.	182-507-0110 182-507-0115 182-507-0120	None Required
277	Not Receiving Medical when Child is Born The mother of the child listed above was not receiving medical assistance when the child was born.	182-505-0115	None Required
279	QMB Start Date - Administrative Use Only	None	None Required

Code	Reason Code Title / Text	WAC References	Free Form Text
280	Not Entitled To Medicare Part A DSHS cannot pay for your Medicare Part B premium because you are not eligible for Medicare Part A. If you have questions about your Medicare coverage, call your Social Security Office. See WAC rule (Washington Administrative Code):	182-517-0300	None Required
281	Waiver Not Approved You need an approved plan of care before we can help pay for your care provider. See WAC rule (Washington Administrative Code):	182-515-1505 182-515-1506 182-515-1510 182-515-1511	We do not have a plan of care for your (type of home or community based (HCB) program).
282	Indian Food Distribution Program Your assistance unit got food from an Indian Food Distribution Program this month. You are not allowed to get food from two FNS (Food and Nutrition Services) programs in one month. See WAC rule (Washington Administrative Code):	388-400-0040	None Required
284	Failed To Meet Spenddown Requirement You didn't give us enough medical bills to meet your spenddown. You can reapply for medical at any time. See WAC rule (Washington Administrative Code):	182-504-0020	None Required
285	Income Exceeds 250% Of FPL (CHIP) The amount of your countable income is more than the maximum for the Children's Health Insurance Program (CHIP). See WAC rule (Washington Administrative Code):	182-505-0100 182-505-0210	The income limit for your family size is $_____
286	Cash Diversion - Not Eligible ForTANF To get Diversion Cash Assistance everyone in your family must be able to get TANF/SFA (Temporary Assistance for Needy Families/State Family Assistance). See WAC rule (Washington Administrative Code):	388-432-0005	If no other reason code or letter: You are not eligible for TANF/SFA because .
288	Ineligible ESLMB Already Receiving MA You are not eligible for the Qualified Individual (QI-1) Program because you are receiving Medicaid Benefits. You are eligible for the State-funded Buy-In Program. We will pay for your Medicare Part A premiums, if you have any, as well as your Part B premiums, coinsurance, and deductibles. See WAC rule (Washington Administrative Code):	182-517-0300	None Required
289	Failed To Appear For Application Appointment CA/MA/FA You or a representative did not appear for the scheduled appointment required to determine your eligibility for financial, medical or food stamp assistance. See WAC rule (Washington Administrative Code):	388-400-0070 388-406-0050 388-406-0060 388-406-0035 388-452-0005	None Required

Code	Reason Code Title / Text	WACReferences	Free Form Text
290	Overdue Incapacity Review You were approved for a limited time period based on the medical information we had. That time period is over and we did not get your updated medical information.	388-447-0110 388-400-0060 388-449-0150	None Required
292	Group Home Decertified The facility where you live is no longer certified to get food assistance for you. You can't get food assistance while you live there. See WAC rule (Washington Administrative Code):	388-408-0040 388-460-0010	You live at (Name of Facility).
294	Changed To Family Planning Since you are no longer pregnant, the type of medical coverage you receive has changed. You will start receiving coverage for only family planning services. See WAC rule (Washington Administrative Code):	182-505-0115	None Required
295	Dependent Has Creditable Medical Coverage (CHIP) Your child/children have other medical coverage. See WAC rule (Washington Administrative Code):	182-505-0215	None Required

300 Series Reason Code Protocols

Revised January 21, 2020

Purpose:

300 Series Reason Code Protocols
Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.
For ACES Procedures go to ACES Letters in the ACES User Manual.
Staff must add explanatory text to the notice unless the "Recommended Free Form Text" column specifies "None Required."
The "Recommended Free Form Text" is the suggested wording for a reason code requiring mandatory explanation to the client.

Code	Reason Code Title / Text	WAC References	Recommended Free Form Text
300	Non-Payment of Premium According to our records, you have not paid all required premiums. See WAC rule (Washington Administrative Code):	182-523-0120	None Required
301	Exceeds Income Standard Your income is over the limit that is allowed for this program. See WAC rule (Washington Administrative Code):	182-505-0100 182-505-0240 182-509-0001 182-511-1050 182-512-0010 182-513-1205 182-513-1245 182-513-1395 182-515-1508 182-515-1513 182-519-0050 182-517-0100 388-450-0015 388-450-0162 388-450-0165 388-478-0060 388-478-0090	None Required
302	Change In Child Support The amount of legally obligated child support that you pay has changed. See WAC rule (Washington Administrative Code):	388-450-0185	The amount of child support you must pay changed from $_______ to $_____.
304	Additional Requirements Change The amount of assistance you get for additional requirements has changed. See WAC rule (Washington Administrative Code):	388-478-0050 388-473-0010 388-473-0020 388-473-0040 388-473-0050 388-473-0060	The amount of money you get for (type of additional requirement) has changed from $__ to $__ because .
305	Food Assistance Change Due To Change In Grant Amount Your food assistance is changing because the amount of your cash assistance has changed. See WAC rule (Washington Administrative Code):	388-412-0015 388-450-0025	None Required
306	Change In Unearned Income The amount of unearned income you get has changed. See WAC rule (Washington Administrative Code):	388-418-0020 388-450-0025 388-450-0162 182-504-0120 182-509-0320 182-509-0325 182-512-0750 388-492-0020 388-492-0030 388-492-0070	Your income from (source) has changed from $___ to $__.
307	Change In Gross Earned Income The amount of money that you earn has changed. See WAC rule (Washington Administrative Code):	388-450-0030 182-509-0001 182-509-0300 182-512-0010 182-512-0700 388-418-0020 388-450-0030 388-450-0162	Your gross earned income has changed from $___ to $___.

Code	Reason Code Title / Text	WAC References	Free Form Text
320	Exceeds Gross Income Limit Your income is higher than the income limit for this program. See WAC rule (Washington Administrative Code):	182-509-0001 388-450-0165 388-478-0060 388-478-0090	The limit for your household size is $___.
321	Change In Net Deemed Income The amount of income we consider available to you from an outside source has changed. See WAC rule (Washington Administrative Code):	388-450-0100 388-450-0105 388-450-0115 388-450-0120 388-450-0155 388-450-0130 388-450-0140 388-450-0160	We are counting $__ of (Name)'s income.
323	Change In Home Maintenance Exemption The income amount that you are allowed to keep to pay for home expenses is called a home maintenance allowance. Yours is changing because: You have been getting it for 6 months; Your doctor says you have to stay longer; or The amount of your home expense has changed. See WAC rule (Washington Administrative Code):	182-513-1380	Your home maintenance amount has changed because ________. (add specific details, e.g. “Your rent has changed from $____ to $_____.” Or “On __(date)___, Dr. _____ told us you can’t return home before _____.”)
324	Child Support More Than Grant Your regular monthly child support payment is more than the grant payment. See WAC rule (Washington Administrative Code):	388-422-0030	None Required
327	Change In Recoupment We are taking a different amount from your benefits to repay an overpayment. See WAC rule (Washington Administrative Code):	388-410-0005 388-410-0010 388-410-0015 388-410-0030	None Required
328	Excess Net Income - Food Assistance You can’t get food assistance because your income is above the limit for your household size. See WAC rule (Washington Administrative Code):	388-478-0060	The limit for your household size is $ .
329	Change In Dependent Care Costs The amount you pay for childcare or dependent care has changed. See WAC rule (Washington Administrative Code):	388-450-0170 388-450-0185	The amount you pay has changed from $____ to $____.

Code	Reason Code Title / Text	WAC References	Free Form Text
330	Lump Sum Your resources are over the limit for this month because of your lump sum payment. See WAC rule (Washington Administrative Code):	182-512-0300 388-450-0245 388-470-0005	You got $__ from __ on 00/00/00. Your countable resources are now $__. Your resources cannot be more than $_____ (specify resource limit for household size). If the grant is suspended: We will be subtracting $_____ from next month’s grant. This reduction is for one month only. If the grant is terminated: Your lump sum payment is more than the need standard for two months. You can reapply for a cash grant in (month).
331	Excess Net Income - Cash Assistance Your net income is over the limit for this program. See WAC rule (Washington Administrative Code):	182-512-0010 182-513-1300 182-515-1500 388-478-0020 388-478-0027 388-478-0033 388-478-0050 388-478-0090	The limit for your household size is $ ____.
332	Change In CPI Allowance Your Personal Needs Allowance (PNA) changed. See WAC rule (Washington Administrative Code):	182-513-1380 182-513-1385 182-513-1205 182-513-1215 182-513-1225 182-515-1507 182-515-1509 182-515-1512 182-515-1514	None Required
334	Exceeds Earned Income Limit Your earned income is over the limit for this program	388-478-0035	The limit for your household size is $____.
335	Change In Uncovered Medical Expense Allocation The amount you can use to pay medical expenses has changed. See WAC rule (Washington Administrative Code):	182-513-1380 182-515-1509 182-515-1514	The amount you can use to pay for the following medical expenses has changed: (Type of expense) from $__to $ .
336	Change In CSMA / FMMA Allocation The amount we can allow for the maintenance of your family members at home has changed. See WAC rule (Washington Administrative Code):	182-513-1385	Your allocation changed from $___ to $___because __________.
338	Not Eligible Until Month After Application Month The person listed above cannot get food assistance for the month they applied in. See WAC rule (Washington Administrative Code):	388-406-0055 388-418-0020	None Required
339	Medical Extension Ends Your medical extension expired and we did not get your review form. If we get it before the end of the month, we will reconsider our decision. If you have already sent it, let me know. If your medical benefits stop and you decide that you still want them, you need to reapply. See WAC rule (Washington Administrative Code):	182-523-0100 182-505-0115	None Required.

Code	Reason Code Title / Text	WAC References	Free Form Text
340	QMB Ineligible - Client Is Not Institutional Related You are no longer eligible for assistance that pays for all or part of your Medicare costs and premiums. The department must count your income differently when you are no longer eligible for Long-Term Care Services, such as Nursing Facility Care, COPES or CAP/OBRA Services. See WAC rule (Washington Administrative Code):	182-517-0100 182-517-0300 182-517-0310 182-517-0320	None Required
341	SSP Rate Change The state supplemental payment rate for all SSI recipients has changed. See WAC rule (Washington Administrative Code):	388-478-0055	None Required
342	Termination/Denial Due to Non-Payment of Premium You didn't pay required premiums.	182-505-0225	None Required
343	Third Party Resource Amount Changed The amount of Third Party Resources you get has changed. See WAC rule (Washington Administrative Code):	182-501-0200 182-513-1380 182-515-1509	The amount of your third party resource has changed from $___ to $__.
345	Home Maintenance Exemption Changed We changed the housing deduction due to one or more of the following: The amount of your housing costs changed. Your income changed. The amount we allow for your housing costs changed.	182-513-1380	None Required.
346	Home Maintenance Exemption Exceeds Time Limit We ended your housing deduction because you received it for the maximum of 6 months.	182-513-1380	None Required.
347	Home Maintenance Exemption Discontinued We ended your housing deduction due to one or more of the following: Your living situation changed. You no longer have a housing cost. Your doctor doesn't expect you to go home within 6 months. Your income or expenses changed. Your marital status changed.	182-513-1380	None Required.
348	Exceeds Ineligible Parent TANF Time Limits A parent in your home received 60 months of TANF/SFA cash assistance for themselves or on behalf of their child(ren) and doesn’t qualify for a time limit hardship extension.	388-484-0005 388-484-0006 388-484-0010	Specify the name of the parent that is referenced.
349	NCS Permanently Disqualified A person is permanently disqualified from receiving TANF/SFA when their case is closed 3 or more times for WorkFirst non-compliance sanction.	388-310-1600 388-400-0005	None Required

Code	Reason Code Title / Text	WAC References	Free Form Text
350	Household Exceeds Allowable Income Household Exceeds Allowable Income	388-450-0162	Your household income of $______is over the limit for this program. The income limit for a household of__ is $_____ (300% of the Federal Poverty Level)
351	Not Aged, Blind, or Disabled -Cash You aren't eligible for benefits under this program because you aren't age 65, blind, or likely to be disabled. 42 CFR 435.541	388-449-0001	None Required

Code

Reason Code Title / Text

WAC References

Free Form Text

350

Household Exceeds Allowable Income

Household Exceeds Allowable Income

388-450-0162

Your household income of $______is over the limit for this program. The income limit for a household of__ is $_____ (300% of the Federal Poverty Level)

351

Not Aged, Blind, or Disabled -Cash

You aren't eligible for benefits under this program because you aren't age 65, blind, or likely to be disabled. 42 CFR 435.541

388-449-0001

None Required

Code	Reason Code Title / Text	WAC References	Free Form Text
386	Diversion Cash Assistance - No Bona Fide Need The expenses you need help with are not covered by the Diversion Cash Assistance program. DCA can only be used to pay for childcare, housing, transportation, expenses to get or keep a job, food and medical expenses. See WAC rule (Washington Administrative Code):	388-432-0005	You asked for help with the following expenses: (List expenses) We cannot cover these expenses because (specify why need is not “bona fide” or is not covered. For example, “You did not give us a written estimate of how much it would cost to fix your car.” Or “You told us you have income of $____ and expenses of $ ____. Based on that, you should have enough money to pay for move-in expenses without our help.”).
388	WA Fund CAP For QI-1 Already Reached Washington gets a limited amount of money for the Qualified Individual (QI-1) Program. There are no more funds available for this year. You can reapply in December for next year. See WAC rule (Washington Administrative Code):	182-517-0300	None Required

Code

Reason Code Title / Text

WAC References

Free Form Text

386

Diversion Cash Assistance - No Bona Fide Need
The expenses you need help with are not covered by the Diversion Cash Assistance program. DCA can only be used to pay for childcare, housing, transportation, expenses to get or keep a job, food and medical expenses. See WAC rule (Washington Administrative Code):

388-432-0005

You asked for help with the following expenses:

(List expenses)

We cannot cover these expenses because (specify why need is not “bona fide” or is not covered. For example, “You did not give us a written estimate of how much it would cost to fix your car.” Or “You told us you have income of $____ and expenses of $ ____. Based on that, you should have enough money to pay for move-in expenses without our help.”).

388

WA Fund CAP For QI-1 Already Reached
Washington gets a limited amount of money for the Qualified Individual (QI-1) Program. There are no more funds available for this year. You can reapply in December for next year. See WAC rule (Washington Administrative Code):

182-517-0300

None Required

400 Series Reason Code Protocols

Revised on October 1, 2024

Purpose:

400 Series Reason Code Protocols
Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.
For ACES Procedures go to ACES Letters in the ACES User Manual.
Staff must add explanatory text to the notice unless the "Recommended Free Form Text" column specifies "None Required."
The "Recommended Free Form Text" is the suggested wording for a reason code requiring mandatory explanation to the client.

Code	Reason Code Title / Text	WAC References	Recommended Free Form Text
401	Over Resources You have too many resources to get assistance right now. See WAC rule (Washington Administrative Code):	182-512-0250 182-512-0300 182-513-1245 182-513-1350 182-513-1395 388-470-0005 388-400-0070	Your resources cannot be more than $_____ (specify resource limit for household size). See the attachment for more information on how we figured out your resources.
402	Lottery/Gambling Disqualification The amount of your lottery or gambling winnings is over the limit allowed for this program.	388-483-0005	Someone in your household won $4,500 or more from gambling or the lottery, received on 00/00/0000. You can't get food benefits until you reapply and meet income and resources for Basic Food.
410	Excess Home Equity - LTC You don't qualify for Long Term Care (LTC) services because the equity in your home is over the $500,000 limit. You may receive LTC services if we approve an undue hardship waiver. We approve hardship waivers when you can show that without LTC services: You will be deprived of housing, food, clothing or medical care. Your life or health will be endangered. Your request must: Tell us in writing the reason you need an undue hardship waiver. Be signed and returned within 30 days of the date of denial or termination of LTC services. Include the name, address and telephone number of the person writing the request. You may authorize your representative, guardian, or facility where you live to file an undue hardship waiver request for you.	182-513-1350 182-513-1367	Explain the equity value we are counting and how we arrived at that number.
411	Transfer Of Resource Disqualification 1 - 12 Months A member of your assistance unit gave something away or sold it for less than fair market value to become eligible for food assistance. See WACrule (Washington Administrative Code):	388-488-0010	(Name) transferred his/her (type of property) on 00/00/00. That (type of property) is worth$ . Since s/he only got $ for it, you cannot get benefits from 00/00/00 to 00/00/00.
416	Transfer of Resources - CA/MA You have a penalty period because you gave something away or sold it for less than fair market value. You can only get benefits now if you prove you cannot pay for your housing, food, clothing, or health needs.	388-488-0005 388-400-0070	Explain the equity value we are counting and how we arrived at that number
417	Transfer of Resources - LTC You transferred, gave away, or sold resources for less than fair market value. This is called uncompensated value.	182-513-1363	None required.
418	Non-Cooperation with Asset Verification You, or those financially responsible for you, didn’t give the agency permission to contact financial institutions to verify resources through the Asset Verification System. We are unable to determine your eligibility. The agency must verify resources to determine eligibility for Aged, Blind or Disabled related medical coverage. If you, or those financially responsible for you, decide to provide authorization for Asset Verification, please contact us. See WAC rule (Washington Administrative Code):	182-503-0080 182-503-0050 182-503-0055	N/A
460	Payment Standard Reduction Payment standards are changing. You do not have administrative hearing rights based on a change in payment standards.	388-478-0020 388-418-0020	None required.
465	State or Federal Law Change – Standards Update State or federal law changed the payment standard for your cash assistance amount.	388-478-0005 388-478-0006 388-478-0015 388-478-0020 388-478-0027 388-478-0033 388-478-0035 388-478-0050 388-478-0090	None Required.
471	No Related Food Stamp AU You don’t receive Basic Food, Food Assistance Program for Legal Immigrants (FAP) or Transitional Food Assistance (TFA).	388-493-0010	None Required.
472	Related TANF AU Exists Someone in your food assistance unit receives Temporary Assistance for Needy Families (TANF) or State Family Assistance (SFA).	388-493-0010	None Required.
473	No Qualifying Child You don’t have a qualifying child under the age of 18 in your home.	388-493-0010	None Required.
474	Not Working the Minimum Hours Required We don’t have current proof that you, your spouse, or co-parent works at least 35 hours per week.	388-493-0010	None Required.
475	Food Stamp is the Priority Program We count Working Family Support as income. Approving this program would close your food assistance.	388-493-0010	None Required.
476	Working Family Support Program Terminated The Working Family Support program is ending.	388-493-0010	None Required.

500 Series Reason Code Protocols

Revised on: August 27, 2024

Purpose:

500 Series Reason Code Protocols
Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.
For ACES Procedures go to ACES Letters in the ACES User Manual.
Staff must add explanatory text to the notice unless the "Recommended Free Form Text" column specifies "None Required."
The "Recommended Free Form Text" is the suggested wording for a reason code requiring mandatory explanation to the client.

Code	Reason Code Title / Text Requirement	WAC References	Recommended Free Form Text
501	SSA Denial You aren't eligible for ABD cash assistance because the Social Security Administration denied your application for Supplemental Security Income (SSI).	388-449-0001	(Social Service Specialist provides mandatory free form text via 14-118)
502	Gainful Employment You aren't eligible for ABD cash assistance. We have determined you aren't disabled because you are currently working.	388-449-0005	(Social Service Specialist provides mandatory free form text via 14-118)
503	Acceptable Medical Source (and no medical) You aren't eligible for ABD cash assistance because you didn't provide medical evidence from an acceptable medical source.	388-449-0060	(Social Service Specialist provides mandatory free form text via 14-118)
504	Insufficient Information You aren't eligible for ABD cash assistance because the medical evidence we received doesn't contain enough information to determine if you are disabled.	388-449-0060	(Social Service Specialist provides mandatory free form text via 14-118)
505	Chemical Dependency You aren't eligible for ABD cash assistance. We can't determine if you are disabled because the medical evidence we received shows drug or alcohol use is material to your impairment .	388-449-0060	(Social Service Specialist provides mandatory free form text via 14-118)
506	Duration You aren't eligible for ABD cash assistance because your impairment does not meet the minimum duration requirement.	388-449-0060	(Social Service Specialist provides mandatory free form text via 14-118)
509	Severity You aren't eligible for ABD cash assistance because your impairment is mild and not expected to keep you from working.	388-449-0060	(Social Service Specialist provides mandatory free form text via 14-118)
510	Past Work You aren't eligible for ABD cash assistance because your impairment doesn't keep you from returning to your past work.	388-449-0080	(Social Service Specialist provides mandatory free form text via 14-118)
511	Other Work You aren't eligible for ABD cash assistance because you have the residual functional capacity to be employed.	388-449-0080 388-449-0100	(Social Service Specialist provides mandatory free form text via 14-118)
517	Termination - No Current Medical See INCAP denial form for text	182-508-0005	(Social Service Specialist provides mandatory free form text via 14-118)
518	Medical Evidence Inconclusive The medical evidence we have doesn’t give us enough information to decide whether you are able to work. As of this date, we can’t confirm your eligibility.	182-508-0005	(Social Service Specialist provides mandatory free form text via 14-118)
519	Medical Information Shows Improvement / Decreased Severity The current medical evidence we have leads us to believe that you shouldn’t have received benefits because you were able to work.	182-508-0005	(Social Service Specialist provides mandatory free form text via 14-118)
520	Change In Federal Law There has been a change in the Federal law that regulates this program.	None	None Required
521	Medical Evidence Shows Clear Improvement – Due to Treatment Medical evidence shows clear improvement due to treatment. 20 CFR 416.920	182-508-0005 388-449-0060	On 00/00/00, I got a report form from Dr. (Name of doctor) that said your (specify condition) has improved so much that you can work now. (The Social Worker should provide the FSS with some free-form text via the 14-118).
522	Currently Employed Currently employed.	182-508-0005	(Social Service Specialist provides mandatory free form text via 14-118)
523	Error In Previous Determination Of Incapacity Error in previous determination.	182-508-0005	(Social Service Specialist provides mandatory free form text via 14-118)
525	No Eligibility Review Form We haven't received your eligibility review or renewal form.	182-504-0035 388-434-0005 388-434-0010 388-492-0090 388-492-0110 388-492-0100 388-400-0070	None Required
528	Eligibility Review Form Incomplete The eligibility review or renewal form we received wasn't complete.	388-492-0110 388-492-0100 182-504-0035 388-400-0070 388-434-0005 388-434-0010 388-492-0090	You must return the completed form to us by 00/00/00 in order for your benefits to continue.
530	Termination/Cancer Treatment Ends Prior to Cert Period The Department of Health has determined that your treatment has ended or you no longer meet the requirements of the program.	182-504-0015 182-505-0120	Text should be supplied by unit that works these.
531	Voluntary Withdrawal for Excess Resources You withdrew your request for assistance because you have too many resources to get assistance right now.	182-513-1350 388-406-0050	None required
532	State-Funded LTC - Program Full The state-funded long term care services program is subject to caseload limits. The program is currently full. We aren't enrolling new members at this time.	182-507-0125	NA
533	Employment requirement not met - HWD You don't meet the employment requirements for the HWD program.	182-511-1200	NA
535	Error in Initial Eligibility - Removed Continuous Tracking for Child - For Administrative Use Only	None	Specify the reason for termination and a WAC related to that reason.
536	Error Initial Eligibility - Removed Locked-in Premium Tier. - For Administrative Use Only	182-505-0210	NA
537	TANF/SFA Background Check Failure You can't receive TANF or SFA benefits for the unrelated child living with you because you didn't pass the background check.	388-454-0005 388-454-0006	None Required
538	TSOA Closure You can’t receive services under this program when you are eligible for certain Medicaid programs.	182-513-1615	No Mandatory Freeform Text
540	CEAP Financial Worker Closure- For Administrative Use Only	None	None Required
541	CEAP Program Funds Exhausted - For Administrative Use Only	None	NA
542	Incomplete six-month report We received your change report form. Some information is still missing. We sent you a letter telling you what you need to give to us. We did not get it.	182-504-0105 182-504-0120 182-504-0125 388-418-0011	Specify what is missing.
545	Invalid Working Family Support Composition You can’t be in a separate assistance unit from your spouse or co-parent. If you are eligible for WFS you may be added to your spouse or co-parent’s assistance unit.	388-493-0010	None Required
546	Non-Cooperation with Asset Verification You, or those financially responsible for you, didn’t give the agency permission to contact financial institutions to verify resources through the Asset Verification System. We are unable to determine your eligibility. The agency must verify resources to determine eligibility for Aged, Blind or Disabled related medical coverage. If you, or those financially responsible for you, decide to provide authorization for Asset Verification, please contact us. See WAC rule (Washington Administrative Code):	182-503-0080 182-503-0050 182-503-0055	N/A
549	You asked us to stop TFA; or you are now receiving Basic Food. You asked us to stop your Transitional Food benefits; or We approved your request for Basic Food. See WAC rule (Washington Administrative Code):	388-489-0020	None Required
550	Voluntary Withdrawal You withdrew your request for assistance. See WAC rule (Washington Administrative Code):	182-503-0080 388-406-0050 388-492-0020	None Required
551	Whereabouts Unknown We don’t know where you are. SeeWAC rule (Washington Administrative Code):	388-458-0030 388-492-0020 182-503-0520 182-503-0525 182-504-0105	None Required
552	Failed To Provide Verification You did not give us the information we needed.	182-503-0050 388-400-0070 388-472-0005 388-490-0005 388-458-0020 388-492-0020	On MM/DD/YYYY we asked you to provide the following items by MM/DD/YYYY. We haven't received them. The items we asked for are: List of items
554	RCL Error in Initial Eligibility Not Medicaid Eligible on Day of Discharge	182-513-1235	Describe the reason the client was not initially eligible for Medicaid.
555	Application Opened In Error - For Administrative Use Only	None	None Required
556	Non-Cooperation With Quality Control - Food Assistance You did not cooperate with the food assistance Quality Control reviewer. See WAC rule (Washington Administrative Code):	388-464-0001 388-492-0020 388-492-0120	You cannot get benefits for # months because ___ . You can regain your eligibility by ___ . If you have any questions about this, call the Quality Assurance worker at 000-000-0000.
557	AU Requests Closure You asked us to stop cash, food, or health care coverage.	388-458-0030 388-492-0020 182-503-0080	None Required
558	Failed To Cooperate In Securing Other Income And Resources You have income or resources that you could use but you haven’t made a reasonable effort to get them. If there is a good reason why you have not done this, please tell us. See WAC rule (Washington Administrative Code):	182-503-0050 388-400-0070 388-458-0020 388-472-0005 388-490-0005	You told us that you have (type of income/resource). To become eligible, you must try to make it available by _______ (specify what they must do to make income or resource available).
559	Client Already Received Assistance In Another AU For This Benefit Month Although you can belong to more than one assistance unit, you can only get benefits from one at a time.	388-400-0005 388-400-0010 388-400-0030 388-400-0040 388-400-0060 388-400-0070	You are already getting cash assistance. Or You are already getting food assistance. Or You are already getting medical assistance.
561	AU Screened In Error - System Generated Only	None	None Required
564	Non-Cooperation With TPL Process You did not cooperate in obtaining another source of coverage for your medical care. See WAC rule (Washington Administrative Code):	182-503-0540	You told us that you could get help with medical from (specify TPL source).
566	Refused to Cooperate With Application Process You refused to cooperate in the application process. Based on the information we have, we are unable to determine your eligibility. See WAC rule (Washington Administrative Code):	182-503-0080 388-400-0070 388-406-0035 388-406-0060 388-452-0005 388-492-0020 388-406-0050	You did not ____ . If you need help, let me know and I will try to assist you.
567	Drug / Alcohol Center Loses Certification You cannot receive food assistance. The drug or alcohol center where you live is not a certified public or private nonprofit organization. See WAC rule (Washington Administrative Code):	388-408-0040 388-492-0020	None Required
569	Child Accepted To Foster Care Our rules say that a child who is in foster care for 180 days or more must be taken off cash assistance. See WAC rule (Washington Administrative Code):	388-408-0015 388-454-0015	None Required
570	Child's Temporary Placement Has Ended Your child's absence is no longer temporary.	388-454-0015	None Required
572	User Voided Application - For Administrative Use Only	None	None Required
575	Not Receiving Cash Assistance - For Administrative Use Only	None	None Required
577	Missed Application Deadline - For Administrative Use Only	None	None Required
578	Non-Cooperation with Chemical Dependency Assessment or Treatment You aren’t eligible for assistance because you didn’t cooperate with a chemical dependency assessment or treatment. You aren’t eligible for assistance again until you reapply and cooperate with assessment or treatment.	182-508-0005 388-449-0220 388-400-0055 388-447-0120	(Social Service Specialist provides mandatory free form text via 14-118)
585	DCA Adult Eligible For TANF, Established Loan Repayment - For Administrative Use Only	None	None Required
586	DCA Ineligible To get Diversion Cash Assistance (DCA) everyone in your family must be able to receive Temporary Assistance for Needy Families/State Family Assistance (TANF/SFA). See WAC rule (Washington Administrative Code):	388-432-0005	Specify which DCA requirement was not met.
587	Already Eligible For Program In Different AU - For Administrative Use Only		The following persons aren't eligible for [cash/food] assistance for [MM/YYYY] because they already received [cash/food] assistance in another household: [list name of ineligible persons] NOTE: You may need to manually create a denial or termination letter or add text to the ACES system-generated letter and WAC references.
588	Ineligible QI-1 Already Receiving MA You aren't eligible for the Qualified Individual (QI-1) program because you are receiving Washington Apple Health coverage. See WAC rule (Washington Administrative Code): You are eligible for the State-funded Buy-In Program. We will pay for your Medicare Part A premiums, if you have any, as well as your Part B premiums, coinsurance, and deductibles.	182-517-0300	None Required
589	Failed MA Incapacity Requirements Based on your current medical information, you are no longer disabled under Social Security rules. See WAC rule (Washington Administrative Code):	182-511-1150	None Required
590	Transfer of Resources - Long Term Care You transferred, gave away, or sold resources for less than fair market value. This is called uncompensated value.	182-513-1363 182-513-1367	Explain the amount of the transfer used to determine the penalty or penalties periods. Indicate the dates the penalty period starts and ends.
591	Approved disaster area requirement not met. You don’t live or work in the area approved for disaster food assistance	388-437-0001	None Required
592	No disaster related loss You didn’t have a loss that meets the eligibility requirements for the disaster food assistance program.	388-437-0001	None Required
593	Living in the shelter for the entire disaster period You live in a shelter and plan to remain in the shelter through the end of the disaster period.	388-437-0001	None Required
594	Maximum food allotment received and no food loss reported You received the maximum food assistance benefit for the month of [MM/YYYY and you told us you didn't lose food bought with food benefits as a result of the disaster.	388-437-0001	None Required
595	Exceeds Disaster Gross Income Limit You aren't financially eligible because the amount considered available for your household is over the income and resource limit for this program.	388-437-0001	NOTE: Please manually transfer the dollar amounts from Barcode D-SNAP Computation Tool into the corresponding fields on the second page of the letter. See D-SNAP Policy and Procedures for Staff/Denials for more details. Disaster SNAP Eligibility Standards can be found on FNS website: D-SNAP Resources for State Agencies and Partners \| Food and Nutrition Service (usda.gov)
596	Failure to Pursue Medicaid You aren't eligible for ABD cash or Housing and Essential Needs (HEN) Referral because you failed to pursue Medicaid.	388-400-0060 388-400-0070	(Social Service Specialist provides mandatory free form text via 14-118)
597	Manual WASHCAP Earned Income Termination You can't receive Washington State Combined Application Project (WASHCAP) food assistance because you've been working more than 3 months.	388-492-0030 388-492-0070	None Required
598	WASHCAP Invalid Living Arrangement You can't receive Washington Combined Application Project food benefits because your living arrangement changed.	388-492-0030	State what the invalid living arrangement is.
599	Other - For User Generation Only	None	(If used for ABD or HEN Referral denial or termination, Social Service Specialist provides mandatory free form text via 14-118)

Information about Letters

Revised July 16, 2020

Purpose:

WAC 388-458-0002 The department of social and health services (DSHS) sends you letters to tell you about your case.

Clarifying Information and Worker Responsibilities

WAC 388-458-0025 We send you a change letter if the amount of benefits you are getting is changing.

Clarifying Information and Worker Responsibilities

WAC 388-458-0030 We send you a termination letter when your benefits stop.

Clarifying Information

WAC 388-458-0035 Why do you give me ten days notice before you reduce or stop my benefits?

WAC 388-458-0040 What happens if I ask for a fair hearing before the change happens?

Clarifying Information

Clarifying Information - WAC 388-458-0002

Letters are sent to clients in their primary language. ACES supports eight languages besides English:

Cambodian
Chinese
Korean
Laotian
Russian
Spanish
Vietnamese
Somali

Worker Responsibilities - WAC 388-458-0002

When sending letters to the client, use the client’s current mailing address. If the client did not provide a current mailing address on the application, send the letter to the last known address.

NOTE:

This internal DSHS website can only be accessed by DSHS staff or persons who have been authorized by the department.

Clarifying Information - WAC 388-458-0011

See APPLICATIONS for the timeframes to process the application.

Clarifying Information - WAC 388-458-0016

EBT information is included on this letter. See BENEFIT ISSUANCES for information about EBT.

Worker Responsibilities - WAC 388-458-0016

If you are approving more than one type of assistance on the same letter, list the type and benefit amount for each type of assistance separately. Do not combine or list amounts without a program reference.

Clarifying Information - WAC 388-458-0020

Information or action needed depends on the type of assistance.
Additional rules about providing information or taking required action is found in APPLICATIONS and VERIFICATION.
If the client provides the information or takes the action within the 10-day notice period:
1. Continue benefits at the same amount if the action or information does not result in a reduction of benefits.
2. Treat the information or action as a newly reported change if it causes a reduction in benefits.
See VERIFICATION for information about paying for requested information.

Worker Responsibilities - WAC 388-458-0020

If you are requesting information for more than one type of assistance, tell the client what is needed for each program. For example, you are pending an application for TANF and Basic Food. You need verification of income for both programs, AP forms for TANF, and verification of rent for Basic Food. Specify this on the letter.
Give examples of the types of verification the client can get. For example, if you need verification of the client's wages, tell them on the letter that they can give you copies of their check stubs or a statement from their employer.
If the client provides the information within the 10-day advance period, treat it as newly reported change. See CHANGES OF CIRCUMSTANCES to determine if the change was reported timely and the correct effective date.
Make sure the client has a supply of return envelopes.
If the due date falls on a weekend or holiday, change the due date on the letter to the next business day.

Clarifying Information - WAC 388-458-0025

If you don’t have time to give 10-day notice as needed, the change is effective the month following. To determine if the client has an overpayment, see effective dates in CHANGE OF CIRCUMSTANCES.

Worker Responsibilities - WAC 388-458-0025

If a client is NSA, follow their accommodation plan and the procedures in NSA before reducing or stopping benefits.

Clarifying information - WAC 388-458-0030

For information on return mail, see WAC 388-418-0020 WORKERS RESPONSIBILITIES #9

Clarifying information - WAC 388-458-0040

When clients request a fair hearing within the ten-day notice period, they are automatically given continued benefits unless they tell us that they do not want them.

ACES PROCEDURES

See ACES Letters.

Letters Protocols

Revised March 25, 2011

Purpose:

For ACES Procedures go to ACES Letters in the ACES User Manual.

Letter	Letter Title	Freeform Text Requirement
0002-24	Approval for Expedited Food Assistance	List verification needed. Provide examples of what client can provide.
0004-05	General Denial - No Information	List items that you asked for that were not provided.
0006-03	GA Termination on Reconsideration	State what new information was received and why it did not change the determination.
0006-04	GA Termination for Clear Improvement	On 00/00/00, I got a report form from Dr. (Name of doctor) that said your (specify condition) has improved so much that you can work now. Or You work # hours per week for (employer) as a (position).
0006-05	GA Termination for No Medical Information	On 00/00/00, I asked you to provide some information by 00/00/00. I still need: List of items
0006-06	GA Termination for Medical Evidence Inconclusive	On 00/00/00, I asked you to provide some information by 00/00/00. I still need: List of items
0006-07	GA Termination for No Incapacity - Prior Error	We made a mistake when we put you on GAU on (date). You did not meet our requirements because _________ (enter case specific information regarding the medical information received and why it doesn’t meet severity and/or duration requirements - e.g. “The information we got from Dr. Sun showed your back injury was not severe enough to keep you from doing light work that you have done in the past.”).
0017-01	Supplemental Payment for Cash/Food	We are giving you additional benefits for (Month) because ___________.
0020-01	MN Spenddown	List all bills used to meet spenddown
0020-03	Bills Received-Spenddown Not Met	In the first mandatory freeform text section: List the bills used to meet spenddown / EMER In the second mandatory freeform text section: List all the bills you did not use and why you didn't use them.
0021-01	General Reinstatement for Cash/Food	We are reopening your case because ______________.
0023-01	Missing Verification for Interview	List: The items that you need verification for; If sending the letter for multiple programs, the program that verification requirement applies to; and Examples of what the client can provide.
0023-02	General Request for Information or Action	List: What you need the client to do and/or provide; If sending the letter for multiple programs, the program that verification/action requirement applies to; and If requesting verification, examples of what the client can provide.
0045-02	Cash Assistance Overpayment - Intentional	State why client has an overpayment. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0045-03	Cash Assistance Overpayment - Unintentional	Describe why client has an overpayment. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0045-05	Food Assistance Overpayment - Inadvertent Error	Describe why client has an overpayment. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0045-06	Food Assistance Overpayment - Administrative Error	State why client has an overpayment. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0045-07	Food Assistance Overpayment - IPV	State why client has an overpayment. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0045-08	Medical Assistance Overpayment	State why client has an overpayment. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0045-09	Overpayment Modification	State why the overpayment is being modified. After this, state: See WAC rule (Washington Administrative Code): List appropriate WAC numbers.
0055-01	ADH for 1st or 2nd Offense Before 1-1-97	In the first mandatory freeform text section: State why you think the client broke program rules. In the second mandatory freeform text section: List the evidence we have about the program violation.
0055-02	1st or 2nd Food Assistance Disqualification After 12-31-96	In the first mandatory freeform text section: State why you think the client broke program rules. In the second mandatory freeform text section: List the evidence we have about the program violation.
0055-03	ADH for 1st or 2nd Offense/Duplicate Participation	List the evidence we have about the program violation.
0055-04	ADH for Permanent Disqualification	In the first mandatory freeform text section: State why you think the client broke program rules. In the second mandatory freeform text section: List the evidence we have about the program violation.
0070-03	ETR Not Requested	State why you are not forwarding the request for a decision.
0070-05	ETR Denial	State why the ETR was denied.
0085-01	WorkFirst Non-Participation Appointment	According to your IRP, you are supposed to (State what requirement of the IRP the client is not meeting). State what information you have that leads you to believe this. (If this appointment will also be a case staffing, then enter the following text):At this appointment, we will also be reviewing your participation in the WorkFirst program with other involved agency staff. I have invited (List agency staff) to this appointment.
0085-02	Food Assistance E&T Good Cause	As part of your E&T (Employment and Training) requirements, you are supposed to (state what E&T requirement the client is not meeting). State what information you have that leads you to believe this.
0085-03	Missed Appointment or Activity for IRP	According to your IRP, you are supposed to (State what requirement of the IRP the client is not meeting). State what information you have that leads you to believe this.

Reason Codes

Revised July 31, 2015

Series Reason Code Protocols

Click on the Reason Code Series number to go to the list of codes in that series in the chart below
In the chart, click on a specific reason code to go directly to the Reason Code Series page and the code you have selected.

100's	200's	300's	400's	500's	600's

The Reason Codes Series pages will show the following elements for each reason code:

Code Number
Reason Code Title / Required Text
WAC Reference
Free Form Text

For ACES Procedures go to ACES Letters in the ACES User Manual.

101	102	103	104	105	106	107	109
110	111	112	120
130	131	132	134
141	142	160	161	162	163	164
187	188	195

200	201	202	203	204	205	206	207
208	209
210	212	213	214	215	218	219
220	221	222	223	224	225	226	227
228	229
230	232	233	235	237	238	239
240	241	242	243	244	245	246	247
248	249
250	251	252	254	255	256	257	258
259
260	261	262	263	264	265	266	268
269
271	272	275	276	279
280	281	282	283	284	285	286	287
288	289
290	292	293	294	295	296	297	298
299

300	301	302	304	305	306	307
320	321	323	324	327	328	329
330	331	332	334	335	336	338
339
340	341	342	343	345	346	347	348
349	350	351
386	388

401	410	417
411	416	460

501	502	503	504	505	506	509
510	511	517	518	519
520	521	522	523	525	528	530
531	532	533	535	536	537
540	541	542	546	549
550	551	552	555	556	557	558	559
561		564	566	567	569
570	572			575	577	578
585	586	587	588	589
590				596	597	598	599

600	601	602	603	604	605	606	607
608	609

Letters

100 Series Reason Code Protocols

Purpose:

200 Series Reason Code Protocols

Purpose:

300 Series Reason Code Protocols

Purpose:

400 Series Reason Code Protocols

Purpose:

500 Series Reason Code Protocols

Purpose:

Information about Letters

Purpose:

WAC 388-458-0002 The department of social and health services (DSHS) sends you letters to tell you about your case.

Clarifying Information and Worker Responsibilities

WAC 388-458-0011 DSHS sends you a denial letter when you can't get benefits.

Clarifying Information

WAC 388-458-0016 DSHS sends you an approval letter when you can get benefits

Clarifying Information and Worker Responsibilities

WAC 388-458-0020 You get a request letter when we need more information.

Clarifying Information and Worker Responsibilities

WAC 388-458-0025 We send you a change letter if the amount of benefits you are getting is changing.

Clarifying Information and Worker Responsibilities

WAC 388-458-0030 We send you a termination letter when your benefits stop.

Clarifying Information

WAC 388-458-0035 Why do you give me ten days notice before you reduce or stop my benefits?

WAC 388-458-0040 What happens if I ask for a fair hearing before the change happens?

Clarifying Information

Clarifying Information - WAC 388-458-0002

Worker Responsibilities - WAC 388-458-0002

Clarifying Information - WAC 388-458-0011

Clarifying Information - WAC 388-458-0016

Worker Responsibilities - WAC 388-458-0016

Clarifying Information - WAC 388-458-0020

Worker Responsibilities - WAC 388-458-0020

Clarifying Information - WAC 388-458-0025

Worker Responsibilities - WAC 388-458-0025

Clarifying information - WAC 388-458-0030

Clarifying information - WAC 388-458-0040

ACES PROCEDURES

Letters Protocols

Purpose:

Reason Codes