SHARE:

introductionsection

«
»
Variable Question text Label
ask_applicationask applicants and beneficiaries
intro1aDo you currently receive ^FLSSDI or ^FLSSI?currently receive SSDI or SSI
intro1a_2Do you receive ^FLSSDI or ^FLSSI?what receive SSDI or SSI
intro1bHave you received ^FLSSDI or ^FLSSI in the past? received SSDI or SSI
intro2aAre you married, or do you have a partner who you live with? married or partner
intro2bIs your spouse/domestic partner currently receiving, or has ever received, Social Security Disability Benefits (SSDI) or Supplemental Security Income (SSI)?spouse receiving or received SSDI or SSI
intro3Have you ever applied for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) in the past?ever applied for SSDI or SSI
intro3bDo you currently have a health condition that prevents you from working or that significantly reduces the amount of work you can do? currently have health condition prevents from working or reduces
intro4aHave you ever had a health condition that prevented you from working or that reduced the amount of work you could do?ever had health condition prevented from working or reduced work
intro4bWhat was the condition you had that prevented you from working/reduced how much you could work?what health condition prevented from working or reduced work
intro4c_monthWhen did you stop working, or reduce how much you work, due to your health condition/s?month when stop working, or reduce how much work, due to health condition/s
intro4c_yearyear when stop working, or reduce how much work, due to health condition/s
intro4dDo you expect to be able to work normally in 12 months or less?expect to be able to work normally in 12 months or less
intro4eFor how long did this condition prevent you from working or significantly reduce the amount of work you could do?long did condition prevent from working or significantly reduce the amount of work could do
intro5aDo you have any friends or family members who have a health problem that negatively affects whether and how much they can work?any friends or family members who have health problem
intro5bWho do you know that has a health problem that prevents them from working? Please select all that apply.who know has health problem
intro6aDo you have any friends or family members who receive Social Security disability benefits (^FLSSDI2 or ^FLSSI2)?any friends or family members who receive SSID or SSI
intro6bWho do you know that receives Social Security disability benefits (SSI or SSDI)? Please select all that apply.who know receives SSI or SSDI