500 Series Reason Code Protocols

Revised April 29, 2016

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.

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 does not give us enough information to decide whether you are able to work. As of this date, we cannot 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 should not 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

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 got your Mid Certification Review 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

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 00/00/00, I asked you to provide some information by 00/00/00. I still need:

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. SeeWAC 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 your cash, food, or healthcare assistance.

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 (specifyTPL 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 WACrule (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 WACrule (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 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

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 have a penalty period because you gave away a non exempt asset or sold it for less than fair market 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.

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 Combined Application Project food assistance because you've been working more than three months.

388-492-0030 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)