Worker's compensation in and of itself is not incapacity, but usually passes the test once the Department does the Incapacity determination. They must also meet the work quarters test unless they received unemployment benefits in the last 12 months. If a family meets any of the above criteria, they have passed the categorical relatedness test and then must also meet the resource and income guidelines. If the countable resources or income exceeds the guidelines, they will be given a spend-down to meet. There is no resource test for children under 18 or pregnant women who meet the income guideline.
Clients can withdraw from a spend-down and ask to have a new determination made.
This makes sense when the income is lower that initially stated. There is no resource test. College student under age 23 attending school half time or more must obtain college sponsored insurance. Also, all other college students of any age attending half time or more have other criteria that must be met to qualify and should contact the Department for that information. Applicants must not have insurance coverage for all or part of Rx expenses.