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.

388-474-0012

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