Over the past few years, there’s been “an explosion of technology,” in workers’ comp according to Dr. Robert Hall, corporate medical director of Optum workers’ comp and auto no-fault. 

The industry, which had long hesitated to adopt new tech, has rushed to adopt new safety tools and technologies that help ease the burden of adjusters. These tools have enormous potential — they can prevent injuries from occurring and ease the burden of adjusters.  

 Much has been written about these tools, but less attention has been paid to how technology has improved patient care and can help with return-to-work. Once a claim occurs, technology is helping injured workers navigate the complexities of the workers’ comp system. Providers are using tech to treat workers and manage chronic conditions and adjusters are using it to model claims outcomes and provide better care.  

 “It helps navigate the patient’s progression through their injury care,” said Matthew Byrne, executive director of provider partnerships at FIGUR8. “The patient needs to be first.” 

 Some are hesitant to use these tools, but embracing tech can improve patient care and get injured workers back to their jobs and their health faster, saving money in the process.  

“You always have those innovators and those that are forward thinking, that want to be on the cutting edge. They want to be early adopters. They want to they’re willing to take a chance on the new technology and innovation in hopes that they will get a bigger reward,” Byrne said.  

Using Tech to Connect with Injured Workers 

One of the most common ways technology is being applied within workers’ compensation claims is patient communication tools.  

Patients often feel uncertain about how to navigate the workers’ compensation system. They might have questions about how to make appointments with medical providers and how coverage for a workers’ comp injury differs from using their regular health insurance. When adjusters can communicate with injured workers, it helps ease some of this anxiety.  

“Trying to stay connected with the injured employee is really key to developing that relationship. It helps individuals get off on the right footing,” added Jean Feldman, senior director of managed care for workers’ compensation claims at Sentry Insurance.  

 Communication tools, like text chat platforms, can help injured workers’ get their questions answered in a timely manner. Often these platforms operate 24/7, giving workers easy access to get their questions answered.  

 “In terms of new technology tools in workers’ comp, one category where I’ve seen expansion is in the area of patient-facing communication tools,” said Dr. Alana Letourneau, chief clinical strategy officer at Carisk. 

 “By using HIPAA-compliant apps, we’re able to better communicate with patients in real time. This allows for secure information sharing beyond the scheduled check-ins with patients, or beyond the next appointment that they have with a provider.” 

 Patients can opt to share information with adjusters through these tools as well, which can help a claim run more smoothly.  

 “Some interactions might occur through automated text messages, such as reminders for medical appointments, allowing claimants to enter data directly,” said Joel Raedeke, chief technology and data science officer at Broadspire  

 “While this technology enhances efficiency, it doesn’t replace the need for adjusters to engage with claimants personally. This human interaction remains crucial for providing personalized service.” 

 Treating the Whole Person 

 Tech has patient care applications as well. Whether it’s telemedicine systems that help patients in rural areas get the specialized care they need or new advanced medical treatments, patients in workers’ comp are benefiting from how medicine has progressed.  

 Some tech tools can help treat workers’ comp injuries directly, especially severe ones. Hall says he’s seen tools that “can literally reprogram that prosthetic knee remotely. They can reprogram it using a wireless device,” he said. Others can help treat severe conditions like PTSD. There are a few virtual reality tools on the market that help with chronic pain and PTSD. These tools help reprogram the brain’s neural pathways, so that patients feel less pain, fear or stress.  

 “Virtual reality can really help those injured employees that have chronic pain. We have found that our models can help identify those injured employees earlier in the recovery process so that our claims reps can bring forward the right tools to assist them,” Feldman said.  

 They can help improve sleep, too, which is critical for healing from a physical injury. Patients may struggle with sleep due to pain or because of trauma. “If you’re not sleeping, you’re not giving your body the chance to heal from your injury,” Feldman said.  

 Tech can also manage comorbidities. Biometric monitoring devices — like the consumer Apple Watches and Fitbits — can track heart rate, sleep quality and other medical data that can be helpful for treating physicians who are trying to manage comorbidities like high blood pressure or diabetes alongside a workers’ compensation injury. “They can be used to help patients be more actively engaged in the monitoring of chronic medical conditions,” Hall said.  

 These tools need the right patient to be effective, however. If someone doesn’t wear the device, doctors can’t use the data.  

 “If they can be used effectively and intentionally. I believe there’s a tremendous potential for impact, but it all comes down to patient selection,” Hall said. “It’s finding the right patients, who are willing to use the device, who are willing to turn it on every day and are willing to share that information.” 

 Tools for a Safer Return-to-Work 

 Return-to-work is another opportunity where technology can help with claims.  

 “Nearly every research paper you see with regard to workers’ compensation, they all say: the faster somebody gets back to work, it’s better in the long run for both their physical recovery as well as their mental recovery,” said Greg Larson, AVP of workers’ comp claims, Sentry Insurance. 

 Tools are helping adjusters model claims outcomes, so they can be more proactive about getting workers back on the job. Some safety tools have applications post-injury as well. Wearables can help workers be more careful and ease into the return-to-work process.  

 “We have seen the opportunity for wearables as part of return-to-work situations as well,” said Bobbie Schaefer, director of The Hartford’s IoT Innovation Lab.  

 “We’ve had a lot of customers say, whether it’s about a new hire or a person returning to work, ‘We want to be sure that there’s no forceful motion as well as review opportunities where we can assist with ergonomic posture.’” 

The Role of AI  

 Many in the workers’ comp industry are excited about the role AI can play in helping adjusters manage claims and how it can improve claims outcomes. Claims managers are already putting data into AI systems and asking them to detect any red flags and predict claims outcomes.  

 “You can put so much into AI. You can put your whole claim in there and ask it for the information you need. How long should this claim last? What is the likelihood that this is a fraudulent claim? What’s the likelihood that they’re going to have a repeat injury?” said Sarah Galvez, ASP, TRA, CWCA, risk manager/workers’ compensation advocate, Trucordia.  

 It’s easy to see the appeal of these tools. Workers’ comp has long been facing a talent shortage. Adjusters are “overburdened with their caseloads,” Byrne said. Industry professionals are hopeful that artificial intelligence and automation tools will help ease adjuster workloads and reduce the strain of the talent crisis in workers’ comp. 

 “We’re hearing things like, ‘that adjustor started six months ago. It’s going to be really good for them, because they don’t have to go search the internet for a state guideline or state formulary spec,’” said Cliff Belliveau, chief innovation officer at myMatrixx.  

 These tools can play a role in supporting injured worker care. AI can process medical notes and claims files, flagging if an injured worker has been prescribed medications that don’t align with state guidelines and may be dangerous, or helping adjusters note when an injured worker might need additional support.  

“Most of them are focused on understanding and improving outcomes,” said Mike Theis AVP, product analytics and business strategy, Healthesystems. “We’ve seen traction with generative AI and natural language processing applied to clinical documentation, summarizing information, driving efficiency and claims workflows.” 

 Claims modelling is one promising technology that could help drive better care outcomes. “We have over 10 models that run for our workers’ compensation claims,” Larson said. “Some of them identify potential recovery, some of them identify the complexity of the claim early on in the loss, but we have four that are specific to the injured employee.” 

 When it comes to AI, however, the industry is “in the middle of a hype cycle,” according to Belliveau. Adjusters may be applying AI in their jobs, but they’re often doing so in the absence of a broader company strategy or without understanding the risks.  

 “There’s going to be those mistakes along the way, but I think eventually we’ll get most of this figured out,” Belliveau said.  

 It’s important to recognize that AI, like other tech tools, comes with risks. Generative AI systems can hallucinate, giving adjusters false information, and many have biases built into their models. Insurers need to use caution when adopting these tools. That’s why it’s important to have an AI strategy — one that’s developed between the C-Suite and technology experts — rather than just letting adjusters try out tools like ChatGTP and other systems.  

 There’s a lot of uncertainty around this new tech. Insurers will need to communicate with adjusters about when to apply these tools. They’ll also want to ease concerns about tech automating away people’s jobs. AI is not reliable on its own. It needs a human to make sure it doesn’t make a mistake that insurers will be liable for.

Driver Safety Spotlight 

In addition to tools being used post-claim to treat injuries, there are a lot of tools being used to prevent losses as well. Wearables help protect workers. Computer vision systems allow employers to upload a video of their workplace and scan it for safety risks ranging from poor worker ergonomics to uncontrolled aspects of a facility.  

 “At Nationwide we are committed to discovering ways to mitigate risks out of the workplace. Examples of this can be found in Insurtech solutions such as wearable technology and computer vision innovations. Injury prevention apparatuses are the latest advancement that can prevent an injury before it even happens,” said Dale Hoppe, VP, Nationwide E&S/S and workers’ compensation programs. 

One safety area that hasn’t gotten as much attention in workers’ comp: auto claims. Telematics, driver assistance systems and other tools to help people be safer on the road have gotten a lot of attention from auto liability insurers, but they’ve gotten less attention in the workers’ comp world. 

Auto accidents are the costliest workers’ comp lost time claim, per NCCI data. In 2021 and 2022, the average cost for a motor vehicle accident workers’ comp claim was $90,914. 

 “A lot of employers forget that workers compensation claims caused by vehicle accidents generate the largest average claim cost across almost all industry segments,” said Greg Stefan, SVP, risk control, Arch Insurance. 

“There is a tremendous amount of vehicle and driver-related technology available. Everything from how are you screening your drivers? How are you training your drivers? How are you monitoring your drivers?” 

Using tools like advanced driver assistance systems and driver screening systems can help prevent these devastating and costly injuries. These tools can reduce distracted driving and offer forward and rear collision warnings, preventing accidents.   

There are also tools that monitor driver behavior. Many are familiar with how these tools are used in cars — you might even have a device that monitors your behavior to receive a discount an a personal auto policy — but they’re also being applied on factory floors. Forklifts can be equipped with driver monitoring equipment that syncs with wearables to alert both drivers and pedestrians walking on the floor when a forklift is near, reducing accidental collisions that could occur if people are distracted.  

 “When people are being observed doing their job driving forklift or working around a forklift they tend to be more aware of the way they are working or driving,” said Jen Thorson, founder and COO, Modjoul, “whereas with our wearable and driver box, the data informs where issues have and could occur.” &