Objective: This presentation reports the functional improvements of a 47-year old patient, TW, who suffered a traumatic brain injury and has no history of cognitive rehabilitation or individual psychotherapy in the intervening 26 years since his injury. Functional and procedural memory, perception, sequencing, range and appropriateness of emotion, are tracked over a 12 month period of treatment using the Functional Independence Measures (FIM). These monthly assessments note the patient's progress and the functional increases are classified using the International Classification of Functioning (ICF). Method: TW suffered a severe, closed-head injury in a motor vehicle accident in 1987. He was referred for treatment at Biscayne Institutes of Health & Living, Inc., a CARF Accredited Brain Injury specialty program. On initial evaluation at Biscayne Institutes, TW received functional impairment scores classified as severe by the ICF in higher-level cognitive functioning (B 164) and moderate in emotional functioning (B 152). His response to treatment was assessed each month with the overall FIM score, classified using the ICF, then analyzed by a trend analysis. Results: The data indicates that TW showed improvement from severe to moderate in specified areas of higher-order cognitive functioning including short term memory, perception, and organization. The patient also showed improvement in range and appropriateness of emotional expression. Conclusion(s): The use of the ICF to chart functional improvements in various domains highlights the importance of using the ICF to demonstrate efficacy of interdisciplinary treatment especially in complex cases such as this one. This study also demonstrates efficacy of cognitive rehabilitation even many years (26) post-TBI.