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. | 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. |
| 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. |
| 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. | 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): |
| (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): | 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:
| 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): | For refugees: or For asylees: |
| Code | Reason Code Title / Text | WAC References | Free Form Text |
|---|---|---|---|
| 210 | Failed Residency Requirement We don’t consider you a resident of Washington. | 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): |
| (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: |
| 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): | 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): | 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): | 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): | 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): | 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): | 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 months and until you participate. See WAC rule (Washington Administrative Code): | 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): | 388-400-0005
| 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): | 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): | 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. | 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. | 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): | 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): | (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): | 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): | For cash assistance: or For food assistance: | |
| 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): | 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. | 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): | 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): | 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): | (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 can'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): | 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): | 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): | 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): | 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): | 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): | 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): |
| 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
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). | None Required | |
| 276 | Your medical condition doesn’t meet the emergency medical requirements for Washington Apple Health Alien Emergency Medical Coverage. | 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): | 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): | 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): | 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. | 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 |