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Universal behavior screening is an important Tier 1 practice with a tiered system of supports framework in schools. Educational leaders are increasingly using screening and other behavior data to inform decision-making. In this study, we examine whether screening scores predict office disciplinary referrals (ODRs) over time (fall and spring) and within categories of referrals (i.e. minor and major ODRs). We analyzed the fall and spring screener scores of 4,067 urban elementary school students. We found that risk of externalizing concerns in the fall predicted more major and minor ODRs, whereas risk of internalizing concerns predicted only fewer minor ODRs. Additionally, an increase in externalizing concerns over time was associated with more ODRs, whereas an increase in internalizing concerns predicted fewer minor but not major ODRs. Collectively, the results add to the evidence supporting using screening data to inform early identification, intervention, and monitoring of risk.