OBJECTIVE To review the state-federal vocational rehabilitation (SF-VR) system and its utilization by persons with rheumatic conditions. METHODS SF-VR system instruction manuals, and literature on rheumatology rehabilitation, work disability, and rehabilitation counseling were reviewed. National and Massachusetts state SF-VR system data on persons with "arthritis and rheumatism" were analyzed. RESULTS The SF-VR system is used by a small proportion of persons with rheumatic diseases. Fifty-two percent of clients with arthritis are employed after receiving services. CONCLUSIONS Although evidence indicates that VR services for persons with rheumatic conditions improves their chances for reemployment, the SF-VR system is underutilized.