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Title 8: Medicaid Page 26 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Cooperation with Child Support Services Revised October 10, 2025 Good Cause for Refusal to Cooperate A finding of good cause because of emotional harm must be based on a demonstration of an emotional impairment that substantially affects the person’s functioning. Consider the following when deciding if good cause exists based on anticipated emotional harm:  The current and past emotional state of the person subject to emotional harm.  The emotional health history of the person subject to the emotional harm.  The intensity and probable duration of the emotional impairment.  The degree of cooperation required.  The involvement of the child in the liability establishment or medical support enforcement activity to be undertaken. When a claim is based on the client’s anticipation of physical harm, and corroborative evidence is not submitted in support of the claim, investigate the claim if you believe that:  The claim is credible without corroborative evidence.  Corroborative evidence is not available.  Grant good cause if the claimant’s statement and the investigation which is conducted provide sufficient evidence that the client has good cause for refusing to cooperate.  Your immediate supervisor must approve or disapprove your decision. Record the findings in the case record. Client Responsibilities When Filing a Good Cause Claim Legal reference: 441 IAC 75.14 The client must prove the existence of good cause circumstances. Evidence must be provided within 20 days from the date of the claim. If your supervisor approves, you may allow more time in exceptional cases where the evidence is especially difficult to obtain. A good cause claim may be supported with the following types of evidence:  Birth certificates or medical or law enforcement records that indicate the child was conceived as the result of incest or forcible rape.