SECTION 1: FINANCIAL INFORMATION (Chronological)

• Authorization Request Forms
• Corrective Action Plan- Client
• Client Reimbursement Form/Receipts/Proof of Purchase Form
• Cost Estimates (modifications, equipment, etc.)
• Direct Deposit Enrollment/FOCUS Card Enrollment Form
• Invoices
• Service Authorization Copies (optional)
• OJE Timesheet
• OJT Timesheet
• WBLE Time Sheet

 

SECTION 2: BASIC AND CONTACT INFORMATION (Chronological)

• Action Planner
• Application
• BP/Benefits Services Referral Form
• DHHS Release of Information
• Handwritten Informational Notes
• Information Releases from other programs
• Next Steps
• Original photocopy of the front and back of the immigration document if a non-citizen
• Pre-ETS Consent and Information Release
• Release of Information Form and any updates
• Releases to Other Agencies
• Release Form for Video & Media
• SSA-3288 Consent for Release of Information/General
• SSA-3288 Consent for Release of Information/Earnings
• State Vehicle Waiver Form
• Waiver of Parent Signature Form
• WBLE Information Sheet
• Pre-ETS Referral/General VR Referral - Bottom Document

 

SECTION 3: ELIGIBILITY/MEDICAL (Chronological)

• Client Incident Report (Top Document) 
• Audiology Calculating Tool
• BP/Benefits Orientation and Services Documents
• Community Work Assessment (all pertinent forms)
• Documentation Checklist for Adults
• Documentation Checklist for Youth (under age 24)
• Functional Capacity Checklist
• IEP, Multi-Disciplinary Team Report and/or Educational Psychological Report
• Impairment Checklist
• Med./Psych. Information
• Nebraska VR ABI Screen
• Physical Capacities Form
• Request for Medical Information Form
• Section 511 (all pertinent forms)
• Social Security verification documents/BPQY
• All copied information from a previous case record (Bottom Document)

 

SECTION 4: IPE DEVELOPMENT (Pre-Plan)

• IPE (Original and IPE Amendments forms) (Top Documents)
• VR Profile for Supported or Customized Employment
• Discovery Booklet Activities (Optional: Underneath IPE documents)
• Career Planning Preferences (in place of Discovery Booklet)

             *Following Documents Chronological

• AgrAbility Referral
• AgrAbility Assessment Report
• ATP-CPAP Facility Assessment Referral Form
• ATP Referral Form
• ATP Report
• ATP Service and Device Application
• Background Request
• Background Screen Information Release
• Background Screen Results
• Communication Assessment Form
• Consent for a Non-Paid Exploration and/or Assessment Placement
• Consent for a Paid On-the Job Evaluation Placement
• DHHS Registry Check
• Educational Budget Information and/or Budget Worksheet (Post Secondary)
• Vocational Evaluation Referral Form
• Evaluation Assessment Materials
• Evaluation Assessment Report
• Grade Transcripts (Obtained prior to IPE Approval)
• High School Grade Reports (Obtained prior to IPE Approval)
• Independent Living Referral
• Independent Living Assessment forms
• Independent Living Reports
• Informational Interviews
• I-9 Form and Information
• OJE Information Sheet
• OJE Letter Checklist
• OJE On-The-Job Report
• OOS Information and Referral Form to Other Programs
• Pre-ETS Job Exploration Referral
• Post-Secondary Training Justification
• Self-Employment Assessment & Referral
• Self-Employment Exploring Entrepreneurship Workshop Referral
• Self-Employment Discussion Questionnaire
• Self-Employment Business Plan
• Self-Employment Feasibility Referral
• Self-Employment Feasibility Report
• Supported Self-Employment Referral Form
• Summary of Performance
• W4 Employee’s Withholding Allowance Certificate
• WBLE Paperwork (all pertinent forms)
• Summary of Initial Meeting (Bottom Document)

 

SECTION 5: SERVICES AND PROGRESS REPORTS (Post-Plan)

• Weekly Job Search Record (Top Document)
• Job Search Agreement (Second Document)



            *Following Documents Chronological

• All Training Progress Reports
• Consent for a Non Paid Training Placement
• Consent for a Paid On-the-Job Training Placement
• Equipment Agreement Form
• High Cost Approval Request
• Job Facts Guide
• Job Seeking Skills Training Application
• Mediation Referral
• OJT Information Sheet
• OJT On-The-Job Report
• OJT Letter Checklist
• Placement Referral
• Placement Reports
• Résumé
• Referrals to Other Community Organizations
• Supported Employment Referral Form
• Supported Employment Milestones (all pertinent forms)
• Student Financial Aid Report (SFAR) or (SFAR-E)
• Work Opportunity Tax Credit (WOTC)

 

SECTION 6: CORRESPONDANCE

• Successful Outcome Letter, Office Director Letter, Termination Letter, Job Retention letter (OOS Exception) Refusal to Participate form, Refusal of Pre-Employment Transition Services (While still in High School) form.



            *Following Documents Chronological

• Appointment Reminder Post Card 
• Client e-mails (To & From – Relating to progress or case decisions if printed)
• Eligibility/OOS Letter
• OJE/OJT Letters
• Other Letters
• Pleading and Court Orders
• Suicide Call
• Ticket Un-Assignment Form

Except for the results of client background checks, emails from NDE Legal Counsel should never be filed in a client's paper case file (or copied to the QE2 record). Emails may be filed within the email program or printed and retained in a file other than the client paper case file.

Unless otherwise noted, information is to be filed chronologically in the appropriate section of the case file folder with the most recent items toward the top of the respective section.

Information should be filed promptly so that the case file record is current and up to date.

To aid in the accurate filing of agency documents in the case file record, the section number of the case file folder has been added to lower right corner on agency forms. Some forms have two sections of the file indicated and should be filed in the correct section based on the use of the form. Forms from other agencies or programs the agency uses could not be modified to indicate file location.