Road accidents resulting in personal injury are an increasing cost to society. This study is based on 609 accident victims (of whom 521 survived injury) who were in employment when injured and whose claims for personal injury were settled for 5000 pounds or more by one insurance company over 2 years. It examines survivors' residual disablement, return to work and involvement with rehabilitation services. Data on a representative sample of 101 cases are analysed in more detail to identify possible 'predictors' of return to work. Both univariate and stepwise logistic regression analysis suggest that return to work is less associated with clinical variables, on which much medical advice on return to work is based, than with such other variables as time off work, absence of psychological problems and younger age. Very low rates of referral to rehabilitation may indicate that a rehabilitative approach to cost containment is underutilized in comparison with the traditional emphasis on preventive measures and enhanced medical treatment. More effective rehabilitation, however, may require new approaches to clinical case management, especially in orthopaedic departments where most personal injury claimants are treated.