Less than one-third of persons with severe brain injuries who were employed prior to injury are able to become so engaged after. While variables that predict return to work have been studied, the effect of receiving services from the state-federal vocational rehabilitation system has not been examined. There is a marked schism in TBI research between studies based on cohorts selected from admissions to acute trauma or medical rehabilitation units, and studies of persons receiving vocational rehabilitation via the state-federal system. The present study sought to bridge this schism by investigating the vocational rehabilitation experience of a prospective sample of consecutive admissions to a specialized brain injury rehabilitation unit. In cooperation with the Ohio Rehabilitation Services Commission (ORSC), subjects enrolled in the Ohio Valley Center's Suboptimal Outcomes Study were identified in the ORSC management information system and their history of referral, eligibility, and outcome were extracted.