TX HHS Form H1233. Case Review Notice

The TX HHS Form H1233, Case Review Notice, helps individuals review their eligibility for continued assistance. This form is typically used in situations where a resident of a state-supported living center needs to reassess their eligibility for benefits.

This notice requires the individual to complete the enclosed Application for Assistance (Form 1200) and return it in the provided envelope. The application must be signed by the recipient, their spouse, guardian, power-of-attorney, or responsible party. Additionally, proof of all income and bank balances is necessary, which may include copies of award letters, earnings statements, current checking and savings account statements, etc.

If the completed form is not received within 12 days from the date shown above, it will be assumed that assistance is no longer desired, and benefits may be denied. If you have questions or concerns, you can contact the issuing agency, Texas Health and Human Services (HHS), at the address shown above. Key points to note include:

• The form is used for case review and eligibility assessment.
• The application must be signed by the recipient and relevant parties.
• Proof of income and bank balances is required.
• A completed form must be received within 12 days to avoid denial of benefits.