SN | Question | Score |
No, not limited at all | ||
| Normal; no complaints; no evidence of disease | 100 |
| Able to carry on normal activity; minor signs or symptoms of disease | 90 |
Yes, limited a little | ||
| Normal activity with effort; some signs or symptoms of disease | 80 |
| Cares for self; unable to carry on normal activity or to do active work. | 70 |
| Requires occasional assistance but is able to care for most of own needs. | 60 |
| Requires considerable assistance and frequent medical care | 50 |
Yes, limited a lot | ||
| Disabled; requires special care and assistance | 40 |
| Severely disabled; hospitalization indicated although death not imminent | 30 |
| Very sick; hospitalization necessary; active supportive treatment necessary | 20 |
| Moribund, fatal processes progressing rapidly | 10 |
| Dead | 0 |