This questionnaire is primarily designed for work related injury or disability, and asks the question; how impeded is someone’s ability to work as a result of their problem. This questionnaire should often be used in unison with the “Basic Daily Living” questionnaire.

Ability To Work Quiz

Instead of asking for regularity and severity the “Ability To Work” questionnaire asks “Can you perform the activity” and “Discomfort during and after the activity”. The resulting severity scoring system remains the same – the bigger the number the worse the scenario. In terms of documenting improvement and clinical justification it nowadays appears very important to demonstrate that someone’s daily function is either being improved or at least maintained at an acceptable level.

In the cases of chronic work or accident related injury I would also recommend using a relevant body-part questionnaire as well as the anxiety and depression tools. This may sound like a lot of questionnaires but I explain this in two ways:

  1. Someone else is paying for the treatment so you are responsible to demonstrate to them that your program is justified.
  2. If the person wises to continue to receive care then they need to have evidence that it should be continued in the event of independent reviews and third party attempts to cease compensation.

Click Here To Download The Questionnaire As A PDF...


These tools are not designed or intended for use as diagnostic tools. Regardless of the results of these questionnaires it is recommend that you consult a registered primary care health professional who can assist you with diagnosis and management of your health concern. No responsibility is taken for any actions that you may choose to take after completing any of these tools as no therapeutic recommendations are expressed or implied. Any concerns, questions or fears that should arise after completing these questionnaires should be discussed with your health care provider.


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