Comprehensive paid leave programs provide wage replacement for parental, caregiving and medical leave. Existing state paid leave programs do not currently include services aimed at assisting workers who have difficulty returning to their jobs after experiencing a new serious illness or injury. Return to work programs help firms retain employees, improve worker employment and health outcomes, and reduce costs to businesses. In this brief, we discuss the evidence base for expanding investment in return-to-work services for at-risk workers and testing a temporary disability benefit. We propose providing grants to states to test and expand promising models for return-to-work services in conjunction with paid family and medical leave programs. We also propose testing a new temporary disability insurance benefit outside the context of the Social Security Disability Insurance program.