Completely | Completely | ||||||
---|---|---|---|---|---|---|---|
Disagree | Unsure | Agree | |||||
My pain was caused by my work or by an accident at work | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
My work aggravated my pain | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
My work is too heavy for me | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
My work makes or would make my pain worse | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
My work might harm my back | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
I should not do my normal work with my present pain | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
I do not think that I will be back to my normal work within 3 months | 0 | 1 | 2 | 3 | 4 | 5 | 6 |