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Title 8: Medicaid Page 64 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…

Status Action Client has applied for disability benefits. Initial SSA decision is pending. Notify both SSA and DDS about the concurrent application with form 470-2631, Notice of Pending Medicaid Application within 15 working days. Possible responses are:  Have SSA claim and are processing. If so, hold the Medicaid application until the determination has been made.  Have recently completed a disability determination. If so, check for an SDX.  Do not have a claim. If so, check for an SSI denial for reasons other than disability. If SSA denies the client for reasons other than disability, proceed with a disability determination by the Department. Contact the client to explain that HHS will determine disability. Client has applied for disability benefits. SSA denied disability, but decision is not “final.” Deny the Medicaid application based on the SSA denial. Manually issue a Notice of Action using the language listed below this chart. Determine if Medicaid eligibility exists under another coverage group. See SSA Disability Denial and Appeal Process. Client has applied for disability benefits. SSA denied disability and decision is “final.” Client states there is no new disabling condition and the original has not worsened Deny the Medicaid application based on the SSA denial. Manually issue a Notice of Action using the language listed below this chart. Determine if Medicaid eligibility exists under another coverage group. See SSA Disability Denial and Appeal Process. EXCEPTION: For an SSDI denial on a Medically Needy applicant, see 8-J, When a Client Has Been Denied Disability Benefits.