Objective: The Montreal Cognitive Assessment (MoCA) is a screening measure of general cognitive functioning. Among the research on its reliability and validity were studies of individuals with traumatic brain injury and cerebral vascular accident (CVA) in acute care; however, a dearth of research exists on the validity of the MoCA for individuals with CVA or orthopedic problems in inpatient rehabilitation settings. A hypothesis of this study was individuals with CVA would exhibit greater cognitive impairment than individuals with orthopedic problems or from a normative sample. Method: The current matched case-control study included 243 individuals matched for age and education level. The participants in this study were randomly selected from archival data that contained scores for the MoCA. The study design included 3 groups: Control group, orthopedic group, and CVA group of individuals from an inpatient rehabilitation setting. Results: The results of a oneway ANOVA showed that scores on the MoCA differed across groups, F(2,240) = 22.92, p < .001. Tukey post-hoc analyses showed significant differences in scores between all groups: Control group (M = 23.84, SD = 4.06), CVA group (M = 18.54, SD = 5.49) and orthopedic group (M = 20.84, SD = 5.31). Conclusion: The purpose of the study was to explore the construct validity of the MoCA for individuals receiving physical rehabilitation due to CVA or orthopedic problems. The findings support past research that found lower MoCA scores for individuals with CVA in acute care. Future research would benefit from exploring the validity of the MoCA for other special populations.