Design for Survey of Persons with Mental Retardation and Developmental Disabilities: Summary of Recommendations for Survey Questions and Screening Criteria. Design for Survey of Persons with Mental Retardation and Developmental Disabilities: Summary of Recommendations for Survey Questions and Screening Criteria : Table 25

11/29/1989

: Table 25

Social SecurityCurrently receiving2 Reason for receiving: retired, disabled, widowed/surviving child, spouse/dependent child, other, don't know Other reason If disabled: age began receiving benefit
Supplemental Security IncomeCurrently receiving2 Received SEPARATE SSI payment from state/local welfare office as well
MedicareCovered by Medicare (shown sample card) Claim number and coverage recorded from card Covered by optional feature for doctor bills
MedicaidCurrently receiving Record claim number
Food StampsPerson or spouse in H.H. authorized to receive Covered under other person's allotment
Other Public AssistanceReceived welfare such as AFDC, WIC, foster child care, or general assistance Covered under other person's payment __________ (specify type of welfare)