OBJECTIVES: The aim of the study was to assessed the indirect costs associated with multiple sclerosis (MS) from the perspective of the Social Insurance Institution (ZUS) in Poland. METHODS: The estimates were based on data from the Social Insurance Institution referring to year 2013 and focused on absenteeism due to the illness: costs of sick leave, short-term disability due to rehabilitation benefit and the burden of permanent (or long-term) disability due to disability pension in Poland. Cost analysis was performed based on the Human Capital Approach taking into account Gross Domestic Product (GDP) per capita (10 278 EUR) and Gross Value Added (GVA) per worker (24 680 EUR).  RESULTS: Total indirect costs of MS associated with absenteeism in the year 2013 in Poland were 73 633 786 EUR (GDP per capita) and 176 816 568 EUR (GVA per worker). The predominant component of absenteeism of MS was long-term disability (88%). Sick leave and short-term disability costs constituted 9% and 3% of total indirect costs of MS associated with absenteeism, respectively. One sick leave of person with MS generated the cost of lost productivity equal 451 EUR and 1 082 EUR calculated using GDP per capita and GVA per worker, respectively. Indirect cost of short-term disability for one entitlement to the benefit of rehabilitation were 4 506 EUR and 10 821 EUR, respectively. Cost of one long-term benefit equaled for limited period 23 866 EUR (GDP per capita) and 57 308 EUR (GVA per worker), and unlimited period 359 257 EUR (GDP per capita) and 862 683 EUR (GVA per worker) respectively. CONCLUSIONS: MS in Poland generated very high indirect costs. The main component was long-term disability; sick leave and rehabilitation benefit generated lower costs of lost productivity.