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Title 8: Medicaid Page 63 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised October 10, 2025 When the Department Follows an SSA Disability…  The Department will determine disability when the client is claiming that a new disabling condition or a worsening of the original condition has occurred after a final SSA denial. Procedure: Always determine the status of any Social Security Administration activity before processing applications based on disability, regardless of the coverage group for which the person is applying. The SSA status may be:  Benefits have been approved.  The person has not applied with SSA for benefits.  An application for benefits is pending.  An application for benefits has been denied. (See SSA Disability Denial and Appeal Process for more information.) When SSA-administered disability benefits have been approved, proceed with the Medicaid eligibility determination. Use the following chart to determine what action to take based on the SSA status.

Status Action Client receives SSI Determine Medicaid eligibility. Client has not applied for SSI but agrees to file an SSI application within ten days. Notify both SSA and DDS about the concurrent application with form 470-2631, Notice of Pending Medicaid Application within 15 working days. Possible DDS responses are:  Have SSA claim and are processing. If so, hold the Medicaid application until the determination has been made.  Have SSA claim and recently completed disability determination. If so, check for an SDX message.  Do not have a claim. If so, check for an SSI denial for reasons other than disability. If the client has not applied or SSA denies the client for reasons other than disability, proceed with a disability determination by the Department. Contact the client to explain that the Department will determine disability. Client has never applied for SSI and is not willing to do so. Proceed with disability determination by the Department if the client meets all other eligibility requirements.