01. Edit your how do your illnesses injuries or conditions limit your ability to work examples online
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EXERTION QUESTIONNAIRE SINCE YOUR DISABILITY BEGAN 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling in your personal information at the top, including your name and case number.
- For question 1, select your current living situation by circling the appropriate option. If you choose 'Other', provide a brief explanation.
- In question 2, indicate who you live with by circling the relevant choice. Again, explain if you select 'Other'.
- Question 3 requires a detailed description of how your symptoms affect your daily work. Be specific and provide examples.
- Continue through the form, addressing each question thoughtfully. For instance, describe your average daily activities in question 4 and how they impact you.
- Make sure to answer all questions regarding physical capabilities (questions 5-20) accurately, as these details are crucial for understanding your condition.
- Finally, don’t forget to sign and date the form at the end before submitting it.
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