Serious injury or illness can result in crisis that promotes maladaptive coping and traps the patient in a chronic pain, disuse, and atrophy cycle. Coping drives engagement in purposeful activity, so rehabilitation providers should consider not only the physical injury, but how the patient is dealing with it. This starts with an evaluation that is sensitive to work behavior and its effect on displayed function. Objective and functional treatment goals should set the state for expeditious return to work.