OBJECTIVES: To examine the relationship between specific chronic condition combinations and productivity loss measure by missed work days among non-elderly employed adults. METHODS: Cross-sectional study design was implemented utilizing data from the Medical Expenditure Panel Survey (MEPS) for the years 2004, 2006, 2008, 2010 and 2012. Sample consisted of 5,190 employed non-elderly adults (18-64 years) with at least two of the following four chronic physical conditions: Arthritis, Diabetes mellitus, Heart disease, and Hypertension. Unadjusted and adjusted negative binomial regressions were conducted to examine the association between specific chronic condition combinations and missed work days. All analyses were conducted using survey procedures in Statistical Analysis System (SAS) 9.4. RESULTS: Adults with arthritis/diabetes/heart disease had the highest average missed work days (14.42). In the adjusted model, compared to adults with arthritis/hypertension, adults with diabetes/heart disease and arthritis/heart disease/ hypertension had significantly higher missed work days, while adults with diabetes/hypertension had significantly lower missed work days. CONCLUSIONS: Average missed work days was differed by chronic condition combinations. Adults with combinations of diabetes/heart disease, arthritis/heart disease/ hypertension and arthritis/diabetes/heart conditions have high burden of disease in terms of reduced productivity while at work. Workplace health programs that address multiple health conditions at the same time should be implemented to reduce missed work days.