Survey Text

2019 2013 2007 2001
2018 2012 2006 2000
2017 2011 2005 1999
2016 2010 2004 1998
2015 2009 2003 1997
2014 2008 2002 1996
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2019

No questionnaire text is available for this sample.


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2018
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2017
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2016
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2015
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2014
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2013
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2012
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2011
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2010
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

top
2009
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2008
Survey form view entire document:  text  image
IN35
====
Who received Worker's Compensation in [YEAR]?
PROBE: Anyone else receive Worker's Compensation in [YEAR]?
[1. First Name, [Middle Name], Last name-65]
[2. First Name, [Middle Name], Last name-65]
[3. First Name, [Middle Name], Last name-65]
[Code All That Apply]
----------------------------------------------------
(FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES AUTOMATICALLY:) IF ROUND 3, DISPLAY FIRST CALENDAR YEAR OF PANEL FOR [YEAR]. IF ROUND 5, DISPLAY SECOND CALENDAR YEAR OF PANEL FOR [YEAR].
----------------------------------------------------
----------------------------------------------------
CONTINUE WITH LOOP_03
----------------------------------------------------
----------------------------------------------------
ROSTER DETAILS:
TITLE: RU_MEMBERS_1

COL # 1 HEADER: NAME
INSTRUCTIONS: DISPLAY RU MEMBER'S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION:
THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION.
----------------------------------------------------
----------------------------------------------------
ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.
----------------------------------------------------
----------------------------------------------------
ROSTER FILTER:
DISPLAY ALL RU MEMBERS WHO MEET THE FOLLOWING CONDITION:
- PERSON IS A CURRENT RU MEMBER (INCLUDES DECEASED AND INSTITUTIONALIZED MEMBERS)
----------------------------------------------------

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2007
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2003]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2006
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2003]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2005
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2003]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2004
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2003]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2003
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2003]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2002
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2002]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2001
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2001]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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2000
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 2000]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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1999
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 1999]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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1998
Survey form view entire document:  text  image
IN30
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF SECONDARY FILER]
During 1998, how much money did (READ NAME(S) ABOVE) receive from unemployment compensation?
IF TAX FORM IS AVAILABLE, HAVE RESPONDENT REFER TO
FORM 1040, LINE 19
FORM 1040A, LINE 12
FORM 1040EZ, LINE 3
[Enter $ Amount] .......................
REF .................................... -7 [BOX_03]
DK ..................................... -8 [IN30A]
PRESS F1 FOR DEFINITION OF UNEMPLOYMENT COMPENSATION.
----------------------------------------------------
FOR 'NAME OF SECONDARY FILER', DISPLAY THE PERSON'S NAME SELECTED AT IN05 DURING LOOP_01 FOR THE PRIMARY FILER CURRENTLY BEING ASKED ABOUT. IF IN05 WAS NOT ASKED IN LOOP_01 FOR THIS PERSON, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
SOFT RANGE CHECK: 0-100,000
----------------------------------------------------

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1997
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 1997]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------

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1996
Survey form view entire document:  text  image
IN36
====

[PERSON'S FIRST MIDDLE AND LAST NAME]
How much money did (PERSON) receive from Worker's Compensation [in 1996]?
[Enter $ Amount] ....................... [END_LP03]
REF .................................... -7 [END_LP03]
DK ..................................... -8
----------------------------------------------------
SOFT RANGE CHECK: 0-50,000
----------------------------------------------------