This article argues that it is vital to embrace critical reflexivity to interrogate the epistemological beliefs and principles guiding occupation-based scholarship to move away from frameworks that are incongruent with calls for occupational justice. For this purpose, we describe an epistemic tension between the stated intentions to demonstrate that occupation-based work can be a means to create a more just society and the epistemological beliefs that have historically dominated occupation-based scholarship. To exemplify the potential implications of this tension, a critical analysis of Creswell's social justice/transformative design is presented, illustrating that work that expresses a commitment to social justice while relying on positivist/postpositivist assumptions often risks perpetuating injustices through neglecting their sociopolitical construction. Drawing upon critical social theory, we highlight how engagement with critical epistemological assumptions can facilitate addressing the sociopolitical "roots" of occupational injustices and highlight directions for social transformation.