OBJECTIVES To compare the incremental costs and absences due to sick leave (SL) among employees with bipolar disorder (BPD), other mental disorders (OMD), chronic constipation (CC), functional dyspepsia (FD), gastroesophageal reflux disease (GERD), gout, and insomnia. METHODS A 2001-2007 US employee database was used to identify subjects with BPD, OMD, CC, FD, GERD, gout, and insomnia. All studies used two-part regression models to control for differences between employees with the condition and control groups (employees without the condition). SL costs were based on payments made to the employee (adjusted to 2007 US dollars) and absences were based on reported hours missed. Controls (by study) used the average index date of the subjects with the condition. Incremental costs and absences were defined as adjusted differences between the condition cohort and controls and considered significant at P≤0.05. RESULTS Numbers of employees with SL eligibility for the condition/controls (employees without condition) were: BPD 239/85,420; OMD 5508/76,372; CC 920/143,287; FD 918/143,138; GERD 6172/133,466; gout 600/123,461; and insomnia 7951/134,094. All incremental SL cost differences were significant (P<0.05). From highest to lowest, the incremental annual SL costs (condition-control) were: gout=$359(172.5% higher than controls), insomnia=$208(162.1%), OMD=$175(142.4%), GERD=$169(141.1%), CC=$127(133.8%), FD=$120(128.8%), BPD= $94(119.7%). From highest to lowest, the incremental annual absence days were: gout=2.8(178.3% of control), OMD=2.3(186.9%), BPD=1.9(157.0%), insomnia=1.6(175.4%), GERD=1.3(141.5%), FD=0.8(126.7%), and CC=0.7(130.5%). CONCLUSIONS Employees with insomnia, FD, GERD, gout, CC, BPD, and OMD incur more absences and costs than employees without these conditions, suggesting that management of these conditions should focus on both the workplace and health care settings. Because individual salaries were used to calculate the costs for each condition, the differences in the ordering of the incremental days and payments may be attributable to job-related differences between the diseases. Gout had the highest incremental costs and days of any of the studied conditions.