Questionnaire Text

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19. Does this person have a physical, mental, or other health condition which has lasted for 6 or more months and which. . .

19a. Limits the kind or amount of work this person can do at a job?

[] Yes
[] No

19b. Prevents this person from working at a job?

[] Yes
[] No

19c. Limits or prevents this person from using public transportation?

[] Yes
[] No

[The term "health condition" refers to any physical or mental problem which has lasted for 6 or more months. A serious problem with seeing, hearing, or speech should be considered a health condition. Pregnancy or a temporary health problem such as a broken bone that is expected to heal normally should not be considered a health condition.]