Page 83

Official source

Title 8: Medicaid Page 79 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised May 22, 2026 When the Department Determines Disability

Step Action Compare remainder to $1,690 per month. When the countable earnings exceed $1,690 per month, the applicant does not meet the first requirement of being disabled under SSA standards. Deny Medicaid as not disabled. See When the Department Denies Disability. When the countable earnings are less than $1,690 per month, complete a disability determination, as the client is not engaged in SGA. When countable earnings are less than $1,690 per month and there is evidence that an individual may be engaging in SGA, or appears to be in a position to defer compensation, or by special arrangement, is able to suppress earnings, proceed to the next tests. Do the Comparability Test. Compare the client’s work to that of unimpaired people in the area. Look at time, energy, skills, and responsibility. If the work is the same as that done by unimpaired people, the client has SGA and is not disabled. Do the Worth Test. Determine if the client’s work activity is worth more than $1,690 per month. If so, the client is engaging in SGA, even if the client’s work activity is not comparable to that of an unimpaired person. The value of work in the military must be compared to similar work in a nonmilitary setting. Military wages may continue and the client may be placed on limited duty. Ask your area income maintenance administrator or the HHS SPIRS Help Desk to contact Medicaid Policy to determine the actual value of the work.

loading…

Page 83

Official source

Title 8: Medicaid Page 79 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial Non-MAGI-Related Eligibility Revised May 22, 2026 When the Department Determines Disability

Step Action Compare remainder to $1,690 per month. When the countable earnings exceed $1,690 per month, the applicant does not meet the first requirement of being disabled under SSA standards. Deny Medicaid as not disabled. See When the Department Denies Disability. When the countable earnings are less than $1,690 per month, complete a disability determination, as the client is not engaged in SGA. When countable earnings are less than $1,690 per month and there is evidence that an individual may be engaging in SGA, or appears to be in a position to defer compensation, or by special arrangement, is able to suppress earnings, proceed to the next tests. Do the Comparability Test. Compare the client’s work to that of unimpaired people in the area. Look at time, energy, skills, and responsibility. If the work is the same as that done by unimpaired people, the client has SGA and is not disabled. Do the Worth Test. Determine if the client’s work activity is worth more than $1,690 per month. If so, the client is engaging in SGA, even if the client’s work activity is not comparable to that of an unimpaired person. The value of work in the military must be compared to similar work in a nonmilitary setting. Military wages may continue and the client may be placed on limited duty. Ask your area income maintenance administrator or the HHS SPIRS Help Desk to contact Medicaid Policy to determine the actual value of the work.