The number of Japanese working age persons who have experienced a stroke is significantly increasing. In such cases work support is an urgent issue. Although an active cooperation between medical institutions and work support agencies is critical, it has been insufficient, due to an absence of key coordinators with sufficient knowledge in both occupational therapy and work support or vocational rehabilitation. The present paper introduced two case studies to illustrate the importance of the cooperation between medical institutions and work support agencies and discussed reasons why medical institutions have difficulties in supporting persons who have experienced a stroke in their return to work.