Daily Activities Questionnaire
The Daily Activities Questionnaire asks you to describe in detail how you are able to manage the various functions of day-to-day living with your condition.
The Questionnaire asks questions such as:
Describe what you do on an average day.
When you answer this question, be sure to describe how your condition affects your daily life, particularly the changes you have had to make due to your condition. For example, did you have to abandon a hobby or favorite pastime? If so, explain why.
Do you need help completing your chores?
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 a bed, but now I get so dizzy when I bend over that I have to ask friends to make my bed for me.
How often do you listen to the radio or watch TV or read magazines or books?
Have your reading or viewing habits changed due to your condition? Social Security wants to know how your medical condition effects even your recreation or leisure time.
Be sure to list any changes you've made to accommodate your limited abilities. For examples, see the fatigue questionnaire.
The other questions are very specific.
If you review Tips When Completing Questionnaires, you should have no problem completing the form.