Variable 292c
date of last revision: 04/01/06
Family income of person with brain injury and sources of non-employment income for person with brain injury at follow-up evaluation as reported by the best source of information, which is the person with brain injury unless he or she is considered unreliable or is not available.

(1) What is your total family income (approximate combined income of all members of the household)?

(2a) Do you receive income from the following sources? (This applies only to the person with the brain injury.)
(a) Supplemental Security Income (SSI)
(b) Supplemental Security Disability (SSD)
(c) Temporary Assistance to Needy Families (TA or TANF) (Formerly, Aid to Families with Dependent Children - AFDC)
(d) State/Local Welfare (incl. General Relief, Home Relief)
(e) Unemployment Insurance
(f) Workers' Compensation
(g) Private Insurance
(h) Income from Settlement
(i) Other non-employment sources

(2b (a-i)) DELETED - How much income a month do you receive from each source?

Item (1):
01 $9,999 or less
02 $10,000-$19,999
03 $20,000-$29,999
04 $30,000-$39,999
05 $40,000-$49,999
06 $50,000-$59,999
07 $60,000-$69,999
08 $70,000-$79,999
09 $80,000-$89,999
10 $90,000-$99,999
11 $100,000 or more
55 Data collected before codes 06-11 existed; data exist in calculated variable "income".
66 Not due this year. [Code no longer used; data now collected at all follow-ups.]
77 Refused
88 N/A-no *income
99 Unknown

Items (2a: a-i):
1 No
2 Yes
7 Not due this year. [Code no longer used; data now collected in all follow-up years.]
9 Unknown
2 numeric
1 numeric
*To collect this variable, see the instructions and advice in Appendix D, document "17c.Scripts and Strategies for Collecting Income Variable".

For source: "Settlement", exclude legal fees to be paid out of the settlement.

This variable can be collected along with V211I.

Person with brain injury has an annual family income of $16,500, and receives $1,274.35 a month from an account established with money obtained through a lawsuit associated with the injury.

(1) 02
(2a) (1) 1
(2) 1
(3) 1
(4) 1
(5) 1
(6) 1
(7) 1
(8) 2
(9) 1

Traumatic Brain Injury Model System National Database Live Syllabus V10.3
Monday, September 25, 2006 10:36am  .   comments/questions?
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