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 |
|---|---|---|---|
|
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) |
|
|
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) |
|
|
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) |
|
|
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. |
(Social Service Specialist provides mandatory free form text via 14-118) |
||
|
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) |
|
|
Duration You aren't eligible for ABD cash assistance because your impairment does not meet the minimum duration requirement. |
(Social Service Specialist provides mandatory free form text via 14-118) |
||
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Severity You aren't eligible for ABD cash assistance because your impairment is mild and not expected to keep you from working. |
(Social Service Specialist provides mandatory free form text via 14-118) |
||
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Past Work You aren't eligible for ABD cash assistance because your impairment doesn't keep you from returning to your past work. |
(Social Service Specialist provides mandatory free form text via 14-118) |
||
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Other Work You aren't eligible for ABD cash assistance because you have the residual functional capacity to be employed. |
(Social Service Specialist provides mandatory free form text via 14-118)
|
||
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Termination - No Current Medical See INCAP denial form for text |
(Social Service Specialist provides mandatory free form text via 14-118) | ||
|
Medical Evidence Inconclusive |
|
(Social Service Specialist provides mandatory free form text via 14-118) |
|
|
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. |
|
(Social Service Specialist provides mandatory free form text via 14-118) |
|
|
Change In Federal Law |
None |
None Required |
|
|
Medical Evidence Shows Clear Improvement – Due to Treatment Medical evidence shows clear improvement due to treatment. |
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). |
||
|
Currently Employed Currently employed. |
(Social Service Specialist provides mandatory free form text via 14-118) |
||
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Error In Previous Determination Of Incapacity Error in previous determination. |
|
(Social Service Specialist provides mandatory free form text via 14-118) |
|
|
No Eligibility Review Form |
None Required |
||
|
Eligibility Review Form Incomplete
|
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. |
Text should be supplied by unit that works these. | |
|
Voluntary Withdrawal for Excess Resources |
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 |
|
Error in Initial Eligibility - Removed Continuous Tracking for Child |
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. |
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 |
|
CEAP Financial Worker Closure- For Administrative Use Only |
None |
None Required |
|
| 541 | CEAP Program Funds Exhausted - For Administrative Use Only | None | NA |
|
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. |
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): |
N/A | |
|
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): |
None Required |
||
|
Voluntary Withdrawal |
None Required |
||
|
Whereabouts Unknown |
None Required |
||
|
Failed To Provide Verification |
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. |
|
Application Opened In Error - For Administrative Use Only |
None |
None Required |
|
|
Non-Cooperation With Quality Control - Food Assistance |
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. |
||
|
AU Requests Closure |
None Required |
||
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Failed To Cooperate In Securing Other Income And Resources |
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). |
||
|
Client Already Received Assistance In Another AU For This Benefit Month |
You are already getting cash assistance. |
||
|
AU Screened In Error - System Generated Only |
None |
None Required |
|
|
Non-Cooperation With TPL Process |
You told us that you could get help with medical from (specify TPL source). |
||
|
Refused to Cooperate With Application Process |
You did not ____ . If you need help, let me know and I will try to assist you. |
||
|
Drug / Alcohol Center Loses Certification |
None Required |
||
|
Child Accepted To Foster Care |
None Required |
||
| 570 |
Child's Temporary Placement Has Ended Your child's absence is no longer temporary. |
388-454-0015 | None Required |
|
User Voided Application - For Administrative Use Only |
None |
None Required |
|
|
Not Receiving Cash Assistance - For Administrative Use Only |
None |
None Required |
|
|
Missed Application Deadline - For Administrative Use Only |
None |
None Required |
|
|
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. |
(Social Service Specialist provides mandatory free form text via 14-118) |
||
|
DCA Adult Eligible For TANF, Established Loan Repayment - For Administrative Use Only |
None |
None Required |
|
|
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): |
Specify which DCA requirement was not met. |
||
|
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. |
|
|
Ineligible QI-1 Already Receiving MA 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. |
None Required |
||
|
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): |
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. |
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.
|
(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. |
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. |
|
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) |