OBJECTIVE Quantify work loss and costs associated with prescription opioid use disorder (OUD) from the employer perspective. METHODS Retrospective claims analysis to compare missed work days and associated costs between employees with and without an OUD diagnosis in a 12-month period. RESULTS Two thousand three hundred eleven matched-pairs of employees were compared. The mean (SD) number of days missed while waiting for disability benefits (0.24 [1.4] vs 0.17 [1.0]; P = 0.035), absenteeism due to disability claims (9.5 [40.9] vs 5.6 [30.0]; P