Few persons with severe brain injuries who were employed prior to injury are able to become employed after. While variables that predict return to work have been studied, the effect of receiving state-federal vocational rehabilitation services has received less attention.. The present study investigates the vocational rehabilitation experience of 200 admissions to a specialized brain injury rehabilitation unit. Using subjects from the Ohio Valley CenterÂ’s Suboptimal Outcomes Study, this study investigates the role of vocational rehabilitation services in mediating employment outcomes; as well as predictive factors in accessing vocational rehabilitation services, the course of rehabilitation, and subsequent outcome. It was found that in the three-five year period after the injury, approximately half of the subjects were referred for services . Those most likely to be referred were younger, non-white, employed prior to the injury, and had greater motor independence at discharge. Of those subjects who were referred, approximately half were found to be eligible for services. Those most likely to be found eligible were more educated and experienced greater disability at discharge from rehabilitation. Thirty percent of those eligible were closed successfully as employed; premorbid employment was the best predictor of a successful closure.