A federal judge declined on July 29 to pause the rule that determines which Medicaid enrollees can be excused from work requirements on medical grounds. That is why the address on file with the state agency matters as much as the medical letter. Anyone who receives a notice and believes it is wrong should ask the state agency about appealing and request a fair hearing within the stated deadline. Ask your state agency before requesting a letter. Ask the state agency about appealing and request a fair hearing within the stated deadline.