This study investigates the barriers to return to work after burn injury. The electronic records of burn survivors treated at a Regional Burn Center outpatient clinic from 2001 to 2007 were retrospectively reviewed. Inclusion criteria included employment at the time of burn injury and age 18 years or older. Documentation of barriers to return to work were reviewed and classified into eight categories. Logistic regression analysis was used to determine predictors of return to work at more than 1 year. Ordered logistic regression analysis was performed to determine barrier predictors of employment. The authors identified 197 patients for inclusion in the study. The age was 37 +/- 0.8 (mean +/- SEM) and total body surface area burned was 16 +/- 1.3%. Two thirds (n = 132) of subjects returned to work by 1 year. The most common barriers included pain (n = 79), neurologic problems (n = 69), impaired mobility (n = 58), and psychiatric issues (n = 51). Pain was the most frequent barrier to return to work at all time intervals. Significant predictors of return to work at more than 12 months included length of hospital stay, inpatient rehabilitation, electric etiology, and burn at work (P < .05). Impaired mobility was a statistically significant (P < .05) barrier and other medical issues showed a trend toward statistical significance (P = .054) in predicting return to work at more than 12 months. There are many barriers that impede return to work in the burn population, including pain, neurologic problems, impaired mobility, and psychiatric issues. Early identification of those at risk for prolonged unemployment should prompt expeditious referral to comprehensive rehabilitation services that include work hardening and vocational training programs.