The vast majority of the currently available vocational assessments are used to measure a worker's physical body functions and/or work capacity, while very few, if any, can be utilized to measure actual work performance. Within this research project, the authors conducted a brief review of the literature and synthesized the existing evidence related to some of the key vocational assessments that are utilized by occupational therapists. It was found that the current "gold standard" of vocational assessment is the Functional Capacity Evaluation, yet the evidence does not fully support its reliability and validity in determining an employee's ability to safely return to work. Alternative assessment options were explored, emphasizing the utilization of occupation-focused, performance-based assessment strategies. It is concluded that occupational therapists need to take action to develop and promote the use of performance-based measures of actual work ability. Occupational therapists must capitalize on their unique strengths of evaluating occupational performance and take the lead to develop standardized means of assessing, measuring, and predicting work performance and work status.