The problem with video card refurbs is many are returned after failed overclocking and softmod attempts, and some have had the heatsink/fan replaced and then later re-attached. You may also get just a bare card without DVI-VGA adapter, drivers, games.
Newegg/Chief refurbs are not "factory" refurbs tested by the manufacturer, they are cards that came back from people without any visible scorch marks. You can return a defective card if you catch it in time, but you pay the shipping back to them.