Questionnaire Text

Questionnaire form view entire document:  text  image
6. Module -- Disability

1. Has your ability to perform usual activities (learning at school, professional activity, running a household, self-service) been limited due to health problems (disability or chronic disease) for 6 months or longer?

[] 1. Yes, entirely limited
[] 2. Yes, considerably limited
[] 3. Yes, moderately limited
[] 4. No, it is not limited
[] 5. I don't want to answer this question

5. How was your disability/inability to work/impairment classified?

[] 1. Considerable disability or complete inability to work and to live self-sufficiently, or the 1st group of disability, or long-term inability to work on a farm with entitlements to nursing benefits;
[] 2. Moderate disability or complete inability to work, or the 2nd group of disability;
[] 3. Slight disability or partial inability to work, or advisability to re-qualify professionally, or the 3rd group of disability, or long-term inability to work on a farm without entitlements to nursing benefits;
[] 4. Disability for persons up to 16 years of age
[] 5. I don't want to answer this question
Questionnaire instructions view entire document:  text  image
Module 6 -- Disability (questions 1-5)

Questions from 1 to 5 include possibility to refuse to answer the question.

Information about disability of children in the household should be provided by the mother, father or supervisor.

Questions included in the module will make it possible to divide the individuals by classifying them to one of basic disability groups:

- Lawfully and biologically disabled individuals are individuals, who have a legal statement (statements) issued by a proper authority, and who are also limited in performance of typical (basic) activities, which are normal for their age.
- Lawfully disabled individuals, are individuals, who have a legal statement (statements) validating their disability issued by a proper authority
- Biologically disabled individuals, are individuals who are limited in performance of typical (basic) activities, which are normal for their age.
The typical (basic) activities, which are normal for a particular age should be understood as:
- For infants -- proper reactions to external stimuli (crying, laughing, proper gestures and body movements),
- For children attending to preschools -- ability to take part in games and interactive activities with peers,
- For children attending school -- ability to attend school and be present on every type of obligatory classes,
- For professionally active individuals -- work, studying or care about the household,
- For elderly people -- basic activities making it possible to maintain one's own hygiene, do shopping, prepare meals, etc.
Question 1. Has your ability to perform usual activities (learning at school, professional activity, running a household, self-service) been limited due to health problems (disability or chronic disease) for 6 months or longer?
[p.43]
The answer to question 1 is subjective in character; it is based on self-evaluation of the respondent. In the question, there are three levels of limitations when it comes to performance of usual activities and one of the following answers should be indicated: entirely limited, considerably limited or moderately limited. In all three cases, the duration should be taken into consideration, so disability or chronic diseases lasting or presumed to be lasting more than 6 months should be indicated.

Individuals, who do not assume their possibility to perform basic activities as not limited, as well as individuals with short-term illnesses or disabilities should have answer "4. no" indicated.

Individuals, who have refused to answer the question should have answer "5. I don't want to answer this question" indicated.
- "1. yes, entirely limited"
- "2. yes, considerably limited"
- "3. yes, moderately limited"
- "4. no, it is not limited"
- "5. I don't want to answer this question"
Question 5. How was your disability/inability to work/impairment classified?
[p.45]
The question concerns all individuals, regardless of their age, who have confirmed their disability in question 4 (answer "1. yes" have been indicated). In relation to the statement, a proper level of disability/inability to work should be specified by choosing a symbol from 1 to 4. In the case, if a person has 2 or more statements -- the statement confirming the higher level of disability should be taken into consideration. Individuals, who have refused to answer the question should have answer "5. I don't want to answer this question" indicated.
- "1. Considerable disability or complete inability to work and to live self-sufficiently, or the 1st group of disability, or long-term inability to work on a farm with entitlements to nursing benefits,"
- "2. Moderate disability or complete inability to work, or the 2nd group of disability;"
- "3. Slight disability or partial inability to work, or advisability to re-qualify professionally, or the 3rd group of disability, or long-term inability to work on a farm without entitlements to nursing benefits;"
- "4. Disability for persons up to 16 years of age"
- "5. I don't want to answer this question"
Index of valid statements confirming disability w
[The index will be presented in the format:
The authorized authority

Date of issuing of the statement
- Type of statement : Classification (symbol in question 5)]

(Powiat, Voivodeship or National) Team confirming disability

From 01.01.1998
- Considerable disability : Classification 1
- Moderate disability : Classification 2
- Slight disability : Classification 3
- Disability for persons up to 16 years of age : Classification 4

Social Insurance Board

From 17.08.1998
- Complete inability to work and to live self-sufficiently : Classification 1
- Complete inability to work : Classification 2
- Partial inability to work : Classification 3
After 21.11.1999
- Advisability to re-qualify professionally : Classification 3
From 01.01.1998 to 16.08.1998
- Complete inability to live self-sufficiently : Classification 1
- Complete inability to work : Classification 2
- Partial inability to work : Classification 3
To 31.12.1997
- 1st group of disability : Classification 1
- 2nd group of disability : Classification 2
- 3rd group of disability : Classification 3

Social Insurance Board or Farmers' Social Security Fund

To 31.12.1997
- Long-term inability to work on a farm with entitlements to nursing benefits : Classification 1

Social Insurance Board or Farmers' Social Security Fund

To 31.12.1997
- Long-term inability to work on a farm without entitlements to nursing benefits : Classification 3

The Ministry of Defense or The Ministry of Internal Affairs and Administration

To 31.12.1997
- 1st group of disability : Classification 1
- 2nd group of disability : Classification 2
- 3rd group of disability, only in the case of an individual, who qualified for the 3rd group of disability due to overall health condition III : Classification 3