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Title 8: Medicaid Page 82 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 Determines Disability

Test 1: Significant Services and Substantial Income 1. Use only the income of the person’s productivity, not the productivity of the person’s agent (employee or assistant). 2. Subtract any business expenses from the gross self-employment income. Also subtract:  Unpaid help by a spouse, children, or others.  Soil bank income if included in farm income from the tax return.  Impairment-related expenses if not deducted as a business expense.  Business expense paid for by a third party, such as business rent paid by Vocational Rehabilitation or space furnished by a third party. 3. Determine if the income is the same as before the onset of disability. To determine if the onset of disability affected the person’s ability to engage in SGA, use the income of at least the last five years. If the person’s income is the same as before the onset of disability, there is substantial income and the person engages in SGA. 4. If the person’s income is not the same as before the onset of disability, then determine if the earnings are comparable to unimpaired people in the community in the same business. (For farming, add in the value of produce grown for home consumption.) Test 2: Comparability of Work Evaluate work activity using:  Hours worked  Skills  Energy output  Efficiency  Duties  Job responsibilities