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This paper examines the role of employment-focused policies within the US disability system and summarizes findings from several rigorous evaluations of return-to-work supports targeted to people with disabilities. Several empirically validated approaches to providing return-to-work services to people with disabilities in the United States offer lessons on promising practices. The use of rigorous evaluation methods has been influential in convincing policy makers and practitioners of the effectiveness of alternatives to traditional approaches for certain segments of persons with disabilities. However, more work remains in identifying interventions or policies that work broadly for large segments of persons with disabilities, particularly given that most US disability programs include major work disincentives. Systematic tests of broader rehabilitation and disability support approaches could be potentially helpful in addressing some of the limitations in the current system.