This study examines the processes linking physical impairment with symptoms of anxiety. Analyses are based on a representative sample of 967 physically disabled adults (ages 20 to 90) from ten counties of southwestern Ontario, Canada Several hypotheses test the intervening role of disability characteristics, perceived health care efficacy, personal attributes, and social stratification resources. Ordinary least squares (OLS) regression analyses included sets of those intervening variables entered sequentially. Adjustment produces a significant reduction in the association between symptoms of anxiety and impairment--confirming the intervening role of healthcare efficacy and mastery. Moreover, impairment and mastery have synergistic effects such that higher mastery buffers against the anxiety associated with higher impairment. Other findings raise important questions about age, impairment, and the sense of mastery in the contest of healthcare and gender.