Background: Employers offer a variety of absence benefits. It is unknown how benefit design impacts the use of the benefits, the length of the leaves, and payments made over time in patients with Multiple Sclerosis (MS). MS is a high cost chronic condition within the US. Objectives: Use objective data to compare the prevalence of MS, the employees all-cause utilization of short- and long-term disability (STD and LTD, respectively) and workers’ compensation (WC) and explore changes over time. Methods: Retrospective analysis using the WorkPartners Research Reference Database (RRDb) from 2001 to 2019. The WorkPartners RRDb contains information on medical and pharmaceutical claims for over 3 million employees and dependents, plus employee salary, job-related information, absences and payments by benefit for 1.2 million STD, 1.1 million LTD and 1.4 million WC eligible employees. Each year, employees with medical claims for MS were identified. Analysis focused on the annual prevalence and for each absence benefit the % of eligible employees filing leaves, leave length (in days) and the payments as a % of salary. Years were compared with baseline (2001). Disability and WC payments included lump sum distributions and potentially extended beyond the year initiated. Employees who suffer work-related injuries/illnesses receive WC. WC claims without absence from work (medical only) were excluded. Sick leave claims were excluded because leaves may be taken for any reason. All absences for the employees with MS were aggregated based on the year of the claim start date. Some absence benefits were not used in all years. Average days and median percent of salary paid for each benefit were calculated and compared with baseline. Results: During the study period Multiple Sclerosis prevalence averaged 0.2%. At baseline, in 2001, 12.1% of eligible employees with MS filed STD claims, 1.4% filed LTD claims, and 1.2% filed WC claims. Mean STD claims were 51.8 days and paid 71.0% of salary; LTD claims were 219.8 mean days and paid 7.2% of salary; and WC claims were 105 mean days and paid 343.1% of salary. From 2002 to 2019: for STD, 10.7% to 20.5% of eligible employees filed claims lasting from 63.8% to 129.6% of baseline days and 57.3% to 135.6% of salary; for LTD 1.3% to 9.2% of eligible employees filed claims lasting from 61.2% to 1386.3% of baseline days and were paid 129.2% to 810.2% of salary; For WC 0.0% to 1.0% of eligible employees filed claims lasting from 17.1% to 1128.6% of baseline days and were paid 1.6% to 239.5% of salary. Median percent of salary paid was highest in 2004 for STD, 2017 for LTD, and 2008 for WC. Absence claims were longest in 2018 for STD, 2005 for LTD and 2010 for WC. Conclusions: Management of Multiple Sclerosis is a growing concern for employers. Their employees with MS used a different mix of absence benefits over time with varying durations and payments. Using a constant cost or salary-replacement factor over time for all benefits is not accurate or appropriate.