Objective: Study of depression on disability days and work absenteeism in patients with chronic medical disorders (CMDs) is limited. Our objective was to compare annual bed days and missed workdays in CMD patients with and without depression. Methods: For retrospective analysis, we extracted data on >/=18 year-old employed adults from the pooled 2004-5 Medical Expenditure Panel Survey. Data included ICD-9-CM-coded CMD (hyperlipidemia, heart-disease, arthritis/other joint-disorders, chronic obstructive pulmonary disease, hypertension, diabetes), and depression; number of missed workdays and bed days, age, gender, race, poverty level, health insurance, health status (physical, mental), urban residence, and any depression treatment (psychotherapy/antidepressant). For 6,786 CMD patients with and without depression, we compared rates with one or more missed workdays and bed days, and mean number of missed workdays and bed days. Weighted sample estimates and 95 percent confidence limits (CL) were calculated using the Taylor expansion method. In multivariate logistic regression models, after controlling for other characteristics, we examined association of depression with one or more missed workdays and one or more bed days. Results: Compared with those without depression, significantly more CMD patients with depression reported one or more missed workdays [50.26% (SE0.86%) vs. 70.14% (SE2.11%) p<0.001], and one or more bed days [18.51% (SE0.66%) vs.34.24% (SE2.2%), p<0.001]. The mean number of missed workdays (9.93+/-0.94 vs.5.01+/-0.22) and bed days (4.29+/-0.62 vs. 1.03+/-0.08) were also higher in CMD with versus without depression. In multivariate analyses, after controlling for other characteristics including any depression treatment, depression increased the likelihood of one or more missed workdays (adjusted Odds-Ratio, OR 1.41, 95% CL:1.14-1.75, p=0.002) and one or more bed days (OR 1.37, 95% CL:1.07-1.75, p=0.013) in CMD patients. Conclusion: Depression plays a significant role in both absenteeism and bed days in CMD patients in the United States. Effective identification and treatment strategies require the attention of both providers and payers.