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Jacques Chambers, CLU, Benefits Consultant
Social Security, especially, as well as some insurance companies will send the claimant questionnaires once a claim has been filed as part of the claims review process. Some are for specific reasons or conditions such as pain, fatigue, or diabetic questionnaires.
The most common type of questionnaire, however, is the Daily Activities Questionnaire. Although it may have a different name in some states or from some insurance companies, regardless of the title, it is designed to ask how your medical condition affects your daily life and your ability to function.
Questionnaires are a very important part of the claims process and you should spend the time and effort necessary to give a clear picture of your inability to function on a daily basis. Don’t worry about it looking “too good.” We will cover that possibility in this article too.
Often Social Security demands that the form be returned in 10 days. If that is the case with your questionnaire and you will not have it completed in time, call your Disability Evaluation Analyst. The Analyst’s name and telephone number should be on the cover letter of the questionnaire. Tell him/her that you are working on it as rapidly as you are able, but that it may be a few days late. I have never seen a late questionnaire refused if the Analyst has been told in advance about the lateness and it is not more than a few days to a week late.
The Daily Activities Questionnaire is an important document because it is your opportunity to relate all that medical information they are getting from your doctors to how your medical conditions affect your daily life and the problems they cause you. It is especially important to illustrate changes due to fatigue, pain, cognitive limitations, and other “subjective” symptoms.
You need to plan what you are going to write, so it’s a good idea to make a photocopy of the questionnaire to make notes on, or to put trial answers on a blank sheet of paper before completing the actual questionnaire.
First, review your symptoms. Make a list of them. Some people have been dealing with some symptoms for such a long time and have learned to accommodate them so well, they have forgotten about them as symptoms. Put your list somewhere it will be seen frequently, like the kitchen counter, in the TV guide or bedside.
As you go through the next day or two you will likely find yourself doing something differently than you used to. Often that is due to a symptom that you accommodated so well but you forgot about. Do you take longer to groom? Do you short-cut on meal preparation? Do you ration how often you go outside or upstairs? Have your reading, TV, computer habits changed? Do you nap regularly? Note these shifts in habits on your sheet along with your symptoms. After two or three days, you will be ready to draft answers to the questionnaire.
Regardless of how the questions are worded, they want to know what adjustments you have had to make to accommodate your symptoms and what problems you still have even with some accommodation.
Some general rules to follow are:
Print or otherwise make sure you write legibly. No points are given for neatness, so don’t worry about strikeovers or cross-outs, but make sure what you write is readable.
Consider using a computer. It will be much easier to read. Be sure to include every question, preferably typed in bold to distinguish it from your answer.
NOTE: Sometimes, when you use a computer, your completed questionnaire looks “too good for a disabled person to complete.” However, you know how many hours and how many separate sittings you spent getting it to look like it does. If the questionnaire looks “too good,” note at the end of the questionnaire just how much time you spent completing it as well as any symptoms exacerbated by it. If someone assisted by writing, typing, or reviewing, acknowledge that as well.
Don’t leave any blanks. If there is nothing to say, write “N/A” or “None” to let them know you didn’t overlook the question.
Avoid one word answers. Explain why “yes” or “no” is the answer, and, when possible, give an example or anecdote that illustrates your reply.
Don’t be intimidated by small space for answers. If you require more space, simply note “See Attached Sheet,” and put the answer on a blank sheet of paper. Make sure you put your name and Social Security or Claim number on every sheet, and number the answer to match the question.
The questions on a Daily Activities Questionnaire may vary slightly, but they generally cover the same areas in various degrees of detail:
What are your living arrangements? Do you live alone (or is there someone to help with the chores? Do you live in a house or apartment? Give appropriate details. For example, if you live in a two-story dwelling, comment on how you limit your trips up and/or down stairs due to pain/fatigue/etc., and on any accommodations you made in your living arrangements.
Describe what you do on an average day. This is the most important question and should be answered in some detail. Start with what time you get up and why you get up at that time. How long does it take to groom yourself? What do you have for breakfast and who prepares it, or is it just cold cereal or something else easy? How do you typically spend your morning—resting, running errands, going to the doctor?
What about dinner ? Who fixes it? What is it, if you prepare it? How is this different from when you were healthy? Again, note all shortcuts that you use in meal preparation and clean-up, if you do it yourself.
When you answer this question, be sure to describe how your condition affects your daily life, particularly the changes you have had to make in your daily life due to your condition. While many of these items may be covered in later parts of the questionnaire, it never hurts to repeat or mention them and to note that there is a more elaborate answer later in the questionnaire.
Do you need help completing your housekeeping tasks? Here you can explain who helps or does the housekeeping, cleaning, laundry, yard work, and meal preparation. If you do these yourself, be sure to explain how you have adjusted to accommodate these tasks to your condition, i.e., whether you do them more slowly or not as often or in brief periods.
Again, as you answer this question, indicate how your health condition has affected your ability to complete your chores. For example, “I used to be able to change the sheets on the bed, but now I get so dizzy when I bend over my husband (or friends) do it so they only get changed twice a month now.”
Personal Care. This gives you the opportunity to tell how your grooming habits have changed, that it takes longer to complete, or that you don’t groom as carefully or as often as before. What special adjustments have you made due to your condition? One client who had memory problems said: “I keep all my grooming needs in a basket and take them out as I use them so I will know when I have done everything.”
Hobbies and interests. Reading and TV viewing habits. It is more important in this section to contrast your current interests and habits with those when you were healthy. Depending on the symptoms, many people are no longer able to engage in many of the physical activities they enjoyed when they were healthy. They also often find that because of fatigue or loss of cognitive ability, they don’t read novels or watch heavy dramas but favor, lighter and shorter fare. If you still engage in some activities, be sure to give details of any adjustments you had to make because of your condition.
Errands and transportation. They usually will ask about your driving ability or how you get around. They will also ask about shopping, who does it or, if you do, how often. Again, it is important to note any changes in your routine that you have made to accommodate your symptoms. Do you limit your driving to the neighborhood and daytime only? Do you buy smaller sizes so they are easier to carry or does a friend or spouse help with the major shopping trips? Do you have a spouse or friend accompany you on most outings?
Money and bills. This is usually a small section of the questionnaire; however, it can be an important one. If any problems are shown in this area, Social Security may approve benefits, but will insist that you appoint a Representative Payee to receive the benefits and disburse the money on your behalf. Should this occur to you and you believe you are able to handle your own finances, your representative is usually willing to drop that requirement.
Sometimes, you will have issues that aren’t directly addressed in the questions, but they show ways that your disability has affected you and your life. If there is no “catch-all” question at the end, add one to it labeled, “Additional Information.”
If your condition has changed your level of patience or the way in which you deal with your family or with others, be sure to note that, even if not asked. If you have gone from being socially active to a more reclusive lifestyle, tell them about that.
When possible, give an anecdote that illustrates the change you are describing. For example: Name the TV show you turned off because it was too complicated to follow; tell about the stool or small table you placed just outside your door to set items on while unlocking the door; describe what tools and assists you purchased or created to make certain tasks easier on you; describe how you leave some groceries in the car and take them in at a later time.
This is the only opportunity you have to show how the medical condition has affected your life and your ability to function, so be sure to give all details of your changes, limitations and accommodations. It is important to explain it in detail. Do not assume that the analyst will assume anything; explain it thoroughly. In addition to showing how you are unable to work because of your condition, it will also give the analyst a more vivid picture of the human being that is suffering—something that can’t be learned from reading the medical facts.
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[Jacques Chambers, CLU, and his company, Chambers Benefits Consulting, have over 35 years of experience in health, life and disability insurance and Social Security disability benefits. For the past twelve years, he has been assisting people with their rights, problems, and other issues concerning benefits and disability. He can be reached at firstname.lastname@example.org or through his website at: http://www.helpwithbenefits.com.]
Copyright September 2004– Hepatitis C Support Project - All Rights Reserved. Permission to reprint is granted and encouraged with credit to the Hepatitis C Support Project.
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