Eighty-eight out of one hundred twenty people referred for psychiatric evaluation by the Workmen's Compensation Board were found to suffer from catastrophic disability although their residual physical impairment was minimal. A smaller sample of claimants suffering from this 'disproportionate disability' syndrome were compared with a psychiatric control group. It was found that the claimants had a statistically significant inability to solve verbal similarities. This specific cognitive limitation leaves them vulnerable to the severe and chronic disorganization that is the hallmark of the syndrome. They seem unamenable to psychodynamically oriented psychotherapy and may respond more favorably to supportive treatment and environmental manipulation.