The economic burden of pain-related work-disability is undeniable, although it may be exceeded by even larger costs in terms of human suffering. Pain-management programs have generated mixed occupational outcomes, and clinicians face a bewildering array of variables involved in this process. It is proposed that pain management is necessary for successful occupational rehabilitation, although it is not usually sufficient. A pilot project was conducted to test the hypothesis that outcomes could be improved by simultaneously addressing the problems of chronic pain, and long-term unemployment. The outcomes at 3- and 15-months postdischarge from an intervention group (N = 81) who attended a cognitive behavioral program designed to increase productive behavior, were compared with the outcomes over a 6-month period from a waiting list comparison group (N = 102). Virtually no change was observed for the waiting list comparison group, whereas improved rates of return-to-work and participation in other productive activities occurred for the intervention group.