DVR Signal Washington Vocational Rehabilitation Process Watch

V1 survey instrument · preview only

Anonymous participant-experience survey

This page shows the proposed question structure so the survey can be reviewed before any data collection is activated.

Needs review

Collection is not active

Instrument 0.1.0-preview. Target core burden: 3–5 minutes. No answers can be submitted from this preview.

Proposed consent gate

DVR Signal is an independent project, not Washington DVR or DSHS. This voluntary survey asks about one Washington DVR experience for research and aggregate reporting. Do not enter identifying or medical information. Raw participant-level responses will not be published. Because the survey uses no response identifier, a particular anonymous response may be impossible to locate or delete after submission.

Required affirmation: I am 18 or older, understand this notice, and voluntarily agree to participate.

Question map

Core questions and conditional follow-ups

Conditional questions appear only when their trigger applies. “Unknown,” “unsure,” and “not applicable” remain distinct rather than being treated as “no.”

Your DVR episode

  1. RESP-001

    Are you answering about your own Washington DVR experience?

    Options: Yes · No — I am an authorized representative

  2. RESP-002

    Which best describes this DVR episode?

    Options: Current participant · Former participant · Applied but did not receive services · Authorized representative · Other/unsure

  3. CASE-001

    Where is this DVR case now?

    Options: Application/intake · Eligibility determination · Eligible — waiting list · Vocational assessment/employment planning · Developing IPE · Signed IPE/receiving services · Employment services/job search · Employed · Case closed · Disputing/appealing a decision · Unsure

  4. APP-001

    Approximately when did you submit or sign the DVR application?

    Input: month or unknown

  5. APP-002

    Did DVR tell you additional application materials were needed before eligibility could be determined?

    Input: yes no unsure

Eligibility and waiting list

  1. ELIG-001

    Were you determined eligible for DVR services?

    Options: Yes · No · Still waiting · Unsure

  2. ELIG-002 Conditional: ELIG-001=Yes

    Approximately when were you determined eligible?

    Input: month or unknown

  3. ELIG-003 Conditional: eligible_or_pending

    Did you and DVR agree to extend the eligibility determination period?

    Input: yes no unsure

  4. OOS-001

    Were you placed on DVR's Order of Selection waiting list?

    Input: yes no unsure

  5. OOS-004 Conditional: OOS-001=Yes

    Has DVR released your case from the waiting list?

    Input: yes no unsure

  6. OOS-005 Conditional: OOS-004=Yes

    Approximately when were you released from the waiting list?

    Input: month or unknown

Counselor continuity, assessment, and IPE

  1. CONT-001

    How many different DVR counselors have been assigned to this case?

    Options: 1 · 2 · 3 · 4+ · Unsure

  2. CONT-002 Conditional: CONT-001>1

    After a counselor change, which of these occurred?

    Options: Repeated explanation · Repeated work · Missing information · Case stalled · Unclear responsibility · Prior decisions changed · No significant problem · Other/unsure

  3. ASSESS-001

    What is the status of your vocational assessment?

    Options: DVR told me it was complete · DVR told me it is still underway · Some assessment occurred but status is unclear · I do not remember an assessment · Unsure

  4. ASSESS-004

    Was an important employment-goal or service decision made while an assessment you were waiting for was still incomplete?

    Input: yes no unsure na

  5. IPE-001

    Do or did you have a signed IPE?

    Options: Yes · No · Being developed · Unsure

  6. IPE-002 Conditional: IPE-001=Yes

    Approximately when did the IPE become effective or get signed?

    Input: month or unknown

  7. IPE-003

    Did you and DVR agree to extend IPE development to a specific later completion date?

    Input: yes no unsure na

  8. IPE-005 Conditional: IPE-001=Yes

    Did DVR give you a copy of the signed IPE?

    Input: yes no unsure

  9. IPE-006 Conditional: IPE_active_12_months

    If the IPE has been active at least 12 months, has DVR reviewed it with you during the last 12 months?

    Input: yes no unsure na

Employment goal and services

  1. CHOICE-001

    How was your employment goal selected?

    Options: Participant-led · Jointly developed · DVR strongly recommended another goal · Preferred goal not supported · No meaningful choices · No goal yet · Other/unsure

  2. SELF-001

    Did you propose self-employment as an employment outcome?

    Input: yes no unsure

  3. SELF-002 Conditional: SELF-001=Yes

    What happened with feasibility analysis?

    Options: Completed · Started · Requested but not started · DVR decided without one · Not requested · Unsure

  4. SERV-001

    Which DVR services did you need or request?

    Input: multi service categories

  5. SERV-002 Conditional: SERV-001_has_selection

    Which one was most important to your employment goal?

    Input: single from SERV-001

  6. SERV-003 Conditional: SERV-002_answered

    What happened with that service?

    Options: Requested · Discussed · Included in IPE · Approved · Authorized · Received · Completed

Decisions, access, records, and disputes

  1. DEC-001

    Did DVR deny or refuse a service, accommodation, or other request affecting your participation?

    Input: yes no unsure

  2. DEC-004 Conditional: DEC-001=Yes

    Did you receive the response in writing?

    Input: yes no unsure

  3. DEC-005 Conditional: DEC-004=Yes

    Did the written response explain the reason?

    Input: yes no unsure na

  4. DEC-006 Conditional: DEC-004=Yes

    Did it explain your appeal or dispute rights?

    Input: yes no unsure na

  5. ACC-001

    Did you request a disability-related accommodation from DVR?

    Input: yes no unsure

  6. ACC-003 Conditional: ACC-001=Yes

    What happened with the accommodation request?

    Options: Implemented · Partly implemented · Alternative offered · Denied in writing · Denied verbally · No response · Pending · Unsure

  7. REC-001

    Have you asked DVR for your case-service record?

    Input: yes no unsure

  8. REC-003 Conditional: REC-001=Yes

    What happened with that record request?

    Options: Received · Written delay notice · Still waiting · Restricted/denied · Unsure

  9. CORR-001

    Have you found information in your DVR record that you believe was materially inaccurate?

    Input: yes no unsure

  10. COMM-001

    During this case, which communication or continuity experiences occurred?

    Options: Unanswered messages · Unclear case status · Unclear DVR requirements · Disputed missing information · Important verbal-only decisions · Conflicting instructions · Inaccurate meeting/action records · Communication generally clear/case progressed consistently · No significant problem · Unsure

  11. APPEAL-001

    Which dispute-resolution routes have you used?

    Options: Counselor/supervisor review · DVR leadership/case review · CAP · Mediation · Fair hearing/OAH · Discrimination complaint · Other · None

Outcome and evidence

  1. IMPACT-001

    While experiencing the DVR issues described above, which associated impacts did you experience?

    Options: Delayed employment · Lost employment opportunity · Reduced earnings/lost income · Increased debt/financial hardship · Housing instability/loss of housing · Education/training interruption · Increased reliance on family/community help · Reduced ability to participate in DVR · Withdrew from DVR · No significant negative impact · Prefer not to answer · Other

  2. OUT-001

    What is the current outcome/status of this DVR episode?

    Options: Still active · Waiting for services · Employed consistent with IPE · Employed in another occupation · Self-employed · Unemployed · Withdrew from DVR · DVR closed the case · Appealing · Other/unsure

  3. OUT-002 Conditional: employed

    If employed, how much do you believe DVR services contributed to obtaining or maintaining the employment?

    Options: A lot · Somewhat · Very little · Not at all · Unsure

  4. EVID-001

    Do you have records that could support some or all of the events you reported?

    Options: Yes · Probably · No · Unsure