How Aging Workers Are Reshaping the Complexity of Workers Compensation Claims

As more Americans over the age of 55 remain in or return to the workforce, claims professionals are seeing a rise in the complexity of workers’ compensation cases involving this demographic. The challenges are multifaceted—ranging from physiological factors like slower healing and increased risk of infections, to social determinants of health such as limited financial resources or access to care. This evolving workforce trend is expected to continue, with projections indicating that by 2028, over 25% of workers will be 55 or older.

Comorbidities—chronic conditions such as hypertension, diabetes, and COPD—frequently accompany aging and can complicate injury recovery and treatment planning. Medication regimens must be carefully managed to avoid dangerous drug interactions. Additionally, social and psychological conditions like depression or lack of family support can delay recovery timelines and increase costs. Complex claims in this population can also escalate into catastrophic ones, especially if the injury is severe and the worker lacks financial safety nets.

Medical management is critical in these cases. Experts stress the importance of early intervention, coordinated care, and the use of nurse case managers who assess not just the physical injury but the whole person—physically, mentally, and socially. By communicating clearly with stakeholders and aligning treatment plans early, claims handlers can reduce litigation risks, accelerate return-to-work outcomes, and improve the injured worker’s quality of life.

Technology plays a growing role in this space, with artificial intelligence and predictive analytics helping to flag high-risk claims early. These tools enable proactive planning and offer valuable insights into how job duties and work environments are affecting aging employees. While the presence of older workers adds complexity to claims management, it also creates an opportunity for insurers and employers to invest in smarter prevention, risk control, and communication strategies.