Letters Protocols

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.