WA DSHS 14-144A 2013-2025 free printable template

Disability Report Medical Disability Decision DSS 14-144A The Disability Report form, DSS 14-144A, gathers information about a client's disability, medical evidence, and work history for use by the

How to fill out pdffiller form

How to fill out WA DSHS 14-144A

1. Begin by obtaining the WA DSHS 14-144A form from the official Washington Department of Social and Health Services website.
2. Read the instructions provided on the form carefully to understand the requirements and necessary information.
3. Fill out your personal information in the designated fields, including your name, address, and contact information.
4. Provide details about your household, including information about all members living with you.
5. Report your income by filling out the required sections accurately, including any wages, benefits, or other sources of income.
6. Indicate any expenses that may be relevant, such as childcare costs or medical expenses, if applicable.
7. Review all the information filled out to ensure accuracy and completeness.
8. Sign and date the form where indicated, confirming that all the information provided is true to your knowledge.
9. Submit the completed form as per the instructions, either by mail or electronically, depending on the submission guidelines.

Who needs WA DSHS 14-144A?

1. Individuals or families seeking assistance from the Washington Department of Social and Health Services (DSHS) for programs such as food assistance, cash assistance, or other supportive services.
2. People who need to report changes in their household circumstances, income, or other relevant information to DSHS for eligibility determination.

People Also Ask about

What is considered a disability in Washington state?

Definition of Disability An individual must be unable to engage in any substantial gainful work activity because of a medically determinable physical or mental impairment which is expected to last for 12 continuous months or result in death.

What are three services Washington State provides to citizens?

Economic Services Administration Community Services Office. Division of Child Support. Office of Refugee and Immigrant Assistance. Disability Determination Services.

What is the DSHS stop work form for Washington state?

Stop Work Questionnaire (form 14-438) This form is used when you stop work or self employment. The form should be signed by you but must be completed by your employer. Your employer can also complete this form On-Line.

How do I contact DSHS in Washington state?

Services are available at your local Community Services Office and by phone through the Customer Service Contact Center at 877-501-2233: TTY/TDD users dial 1-800-833-6384 for Washington Relay Service.

How do I file a complaint against DSHS Washington State?

Worker Responsibilities - WAC 388-426-0005 How to make a complaint. Their right to talk to a supervisor. Their option to call customer relations at 1-800-865-7801. Their right to ask for an administrative hearing.

For pdfFiller’s FAQs

Can I create an electronic signature for the pdffiller form in Chrome?

Yes. You can use pdfFiller to sign documents and use all of the features of the PDF editor in one place if you add this solution to Chrome. In order to use the extension, you can draw or write an electronic signature. You can also upload a picture of your handwritten signature. There is no need to worry about how long it takes to sign your pdffiller form.

Can I create an electronic signature for signing my pdffiller form in Gmail?

Create your eSignature using pdfFiller and then eSign your pdffiller form immediately from your email with pdfFiller's Gmail add-on. To keep your signatures and signed papers, you must create an account.

How do I complete pdffiller form on an iOS device?

Get and install the pdfFiller application for iOS. Next, open the app and log in or create an account to get access to all of the solution’s editing features. To open your pdffiller form, upload it from your device or cloud storage, or enter the document URL. After you complete all of the required fields within the document and eSign it (if that is needed), you can save it or share it with others.

What is WA DSHS 14-144A?

WA DSHS 14-144A is a form used by the Washington State Department of Social and Health Services (DSHS) for reporting income and benefits for individuals receiving social services or assistance.

Who is required to file WA DSHS 14-144A?

Individuals who are applying for or receiving social services or public assistance in Washington State are required to file WA DSHS 14-144A.

How to fill out WA DSHS 14-144A?

To fill out WA DSHS 14-144A, individuals should provide accurate information regarding their income, household members, expenses, and any relevant details pertaining to their assistance application.

What is the purpose of WA DSHS 14-144A?

The purpose of WA DSHS 14-144A is to collect necessary information to determine eligibility and the amount of assistance an individual may receive from DSHS programs.

What information must be reported on WA DSHS 14-144A?

Individuals must report information regarding their total household income, bank information, employment details, and any other relevant financial circumstances on WA DSHS 14-144A.