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Title 8: Medicaid Page 85 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

Submit to DDS: Explanation: Form 470-4459 or 470-4459(S) Authorization to Disclose Information to the Iowa Department of Human Services The release allows DDS to contact sources to get the information needed to determine disability. Send a signed release for each source listed on the applicable Disability Report and the additional sources of information for children. This includes releases for any doctors who provide care in a hospital. Additional records, if available: This could include:  Supplemental vocational information.  Any information from the Social Security Administration.  Copies of medical reports or letters from a provider about the applicant’s medical condition from the last 12 months.  For an adult applicant, evidence about work activity, even if the work done was not SGA.  For a child applicant: • School information • Any work history • Any involvement with vocational rehabilitation or other social services Records about a deceased applicant Send either:  Medical records including a note certifying the cause and date of death signed by a medical practitioner, or  A death certificate. (When a person dies at home and has no history of medical treatment for the cause of death, a death certificate is required.) If an applicant moves before a disability determination is completed, provide the new address to DDS by entering it on a copy of the Disability Transmittal, form 470-2472, and sending the form to DDS.