Questionnaire Text

Jul 2021
top
Jul 2021
Questionnaire form view entire document:  text  image
SDIS3
Earlier it was reported that (you/Name) had difficulty (hearing/seeing/concentrating, remembering or making decisions/walking or climbing stairs/dressing or bathing/doing errands alone such as going to the doctor's office or going shopping). Did (you/he/she) ever leave or lose a job because of reason related to (this difficulty /these difficulties)?
(1) Yes
(2) No
[blind] (D) Don't Know
[blind] (R) Refused
If SDIS2 =1 OR [(MLR = 3 OR 5) AND (DS1W or DS2W or DS3W or DW4W or DS5W or DS6W = 1), go to SDIS4, Else if (DS1W or DS2W or DS3W or DW4W or DS5W or DS6W = 1), go to SDIS6.