SNAP ABAWD Exemption Form: Eligibility, Filing, and Denials

A SNAP ABAWD exemption form is the paperwork your state SNAP office uses to document why you should not be subject to the program’s three-month work-requirement time limit. Under the One Big Beautiful Bill Act of 2025, most adults ages 18 through 64 without qualifying dependents lose benefits after three months in any 36-month period unless they work at least 80 hours a month or prove an exemption applies.¹ Filing the right form with your state agency, on time and with the right signatures, is how you keep benefits flowing without meeting the work hours.

Who Can Claim an Exemption

Before you look for the form, confirm which category fits. Federal law, at 7 U.S.C. § 2015(o)(3), sets out these exemptions:¹

Anyone under 18 or over 65.
Anyone medically certified as physically or mentally unfit for employment. This includes people receiving temporary or permanent disability benefits from a government or private source, people whose unfitness is obvious to the state agency, and people who supply a statement from a qualifying medical professional.
Pregnant individuals, at any stage.
A parent or household member responsible for a dependent child under 14. This threshold dropped from 18 to 14 under the new law.²
Anyone already exempt from SNAP’s general work requirements: people caring for a child under six or an incapacitated household member, people in alcohol or drug treatment programs, and students enrolled at least half-time.³
Individuals who meet the statutory definition of Indian or Urban Indian under 25 U.S.C. § 1603.¹

Standalone exemptions that existed before 2025 for veterans, individuals who aged out of foster care, and people experiencing homelessness were eliminated by the One Big Beautiful Bill Act.⁴ If you previously relied on one of those, you now need to meet the 80-hour work rule or qualify under a different category such as medical unfitness.

Finding Your State’s Form

There is no single federal ABAWD exemption form. Each state designs its own, and the version you need depends on which exemption category you are claiming. Medical exemptions almost always require a dedicated form that a healthcare provider signs. Age, pregnancy, or household-composition exemptions may be handled through the general eligibility interview or a shorter self-declaration.

Start with your state’s Department of Human Services or Health and Human Services website and search for “ABAWD exemption,” “SNAP work requirement exemption,” or “SNAP medical exemption form.” Pennsylvania, for example, uses Form PA-1921 for medical exemptions.⁵ Your state’s form will carry a different name and layout, but the information it asks for is broadly similar.

If you cannot find it online, call the number on your SNAP benefit notice or walk into your county office. Caseworkers must screen you for every potential exemption at application and at recertification, so asking directly usually gets the right form into your hands faster than searching alone.

Filling Out the Form

Expect fields for your full legal name, date of birth, and the case identification number you were assigned when you first applied for SNAP. Some states also use a separate record number or county code. Not every state form asks for a Social Security number; Pennsylvania’s does not. Fill in only what your particular form requests.

Most forms then present checkboxes or short sections for each exemption category. Mark the one that applies and be specific. For a caregiver exemption, write in the child’s name and date of birth. For an exemption based on treatment program participation, list the program name and your enrollment dates. If you already receive disability benefits from Social Security, the VA, or a private insurer, attach a copy of your award letter. Under federal regulations, receiving temporary or permanent disability benefits counts as medical certification of unfitness for work, so you may not need a separate medical exam at all.⁶

The Medical Provider Section

Medical exemptions demand more paperwork than the others. A section of the form has to be completed and signed by a qualifying health professional. Federal rules allow a broad range of providers, and most states follow suit. Pennsylvania accepts a physician, physician’s assistant, nurse practitioner, osteopath, psychologist, drug and alcohol counselor, mental health counselor, social worker, midwife, or any medical professional whose services can be reimbursed by Medicaid.⁵ Read your form’s list before you schedule an appointment; other states will list similar categories, but not identical ones.

The provider section usually asks the professional to confirm whether you have a mental or physical condition that reduces your ability to work, whether you are enrolled in a treatment or rehabilitation program, and whether you receive disability-related accommodations from an educational institution. They sign the form, print their name and title, and add their address and phone number. Not every state requires a professional license number or a facility stamp; Pennsylvania’s form requires neither.⁵ Fill in exactly what your state asks for, and don’t invent fields.

Submitting the Form

Once every section is complete and every required signature is on the page, send the form in through one of your state’s authorized channels. Most agencies accept a scanned copy or clear photo uploaded through the online benefits portal. You can also fax it to your local county office or bring it in person. If you mail it, remember that most agencies go by the date they receive it, not the postmark, so allow several days for delivery. Keep a photocopy of the signed form.

Submit as soon as you know a category applies. Your caseworker is not supposed to assign countable months until you have been screened for exemptions, but if the paperwork arrives late, a month or two of your three-month allotment can already be gone. Aim to file during your initial application or at your next recertification interview.

After You Submit

Federal rules require agencies to process initial SNAP applications within 30 days, or seven days for households that qualify for expedited service.⁷ Exemption reviews on an ongoing case can vary in speed, but you should get a written decision by mail. An approval notice will name the exemption category and the benefit period. Check your account or ask your caseworker to confirm that the work-requirement clock has been paused.

If anything is missing, a signature, a legible field, or supporting documentation, a caseworker will contact you. Respond quickly. A month can tick by while an incomplete request sits in the file.

If Your Exemption Is Denied

If your form is denied or your benefits are reduced, the agency has to mail you a written notice explaining why before it can cut benefits. Federal regulations require this advance notice of adverse action. You have the right to a fair hearing. Deadlines vary by state, but in many states requesting a hearing before the effective date of the reduction keeps your current benefits running until a decision comes down.

Bring your copy of the exemption form to the hearing, along with medical records, treatment enrollment letters, or proof of work hours if any of those apply. Many denials turn on something small: a missing signature, an incomplete field, a provider whose title didn’t match the state’s list. Call your caseworker before the hearing and ask whether a simple correction and resubmission will fix it.

1
Office of the Law Revision Counsel. 7 USC 2015 – Eligibility Disqualifications
2
Legal Aid DC. Upcoming Changes to SNAP Benefits
3
Food and Nutrition Service. SNAP Work Requirements
4
Urban Institute. SNAP Cuts in One Big Beautiful Bill Act Leave Almost 3 Million Young Adults Vulnerable
5
Pennsylvania Department of Human Services. SNAP Medical Exemption Form PA 1921
6
Government Publishing Office. 7 CFR 273.24 – Time Limit for Able-Bodied Adults
7
Food and Nutrition Service. SNAP Application Processing Timeliness