November 13, 2025
Every workers’ compensation claim starts with the same goal: help people recover quickly, return to work safely and keep costs in check.
But getting there isn’t as straightforward as it used to be. Rising costs, shifting expectations, earlier attorney involvement and a growing focus on mental health are changing the way claims are managed — and the strategies needed to achieve optimal outcomes.
In this article, we’ll explore:
- What’s making optimal outcomes harder to achieve
- How inflation, litigation, communication shifts and mental health are changing the game
- What it takes now — and how technology is helping
What’s different now
Costs are rising.
Accident rates continue to decline, thanks to safer workplaces and smarter prevention strategies. Despite that decrease, costs are increasing. Wage inflation is up nearly 7% year over year, and medical inflation is climbing steadily. Even if claims are managed exactly as they were a year ago, costs will still rise.
Attorneys are getting involved sooner.
More injured workers are seeking legal representation earlier in the process — often before a dispute even arises. While early attorney involvement can be helpful in some cases, it also introduces unnecessary complexity and costs.
Communication expectations are shifting.
Today’s workforce spans five generations, each with different expectations. Some prefer texts or chats. Others want phone calls or rely on email. Many expect a mix of all these. Meeting workers where they are — with the right tone, timing and channel — is essential to keeping them engaged and informed.
Older workers are staying in the workforce longer.
There are more workers aged 60 and older in the workforce, and we’re seeing a rise in injuries for this age group. Their claims tend to be more complex — with comorbidities to manage, longer durations and extended time away from work.
There’s a deeper focus on mental health.
Injured workers aren’t just navigating physical recovery — they’re often dealing with stress, anxiety, depression or trauma related to the injury, the workplace or the claims process itself. These factors can delay healing and complicate claims.
4 ways to achieve optimal outcomes today
1. Identify complexity early and bring in the right team.
Rising costs aren’t going away — but smarter claims management can help. That starts with having a system in place to spot complexity early and respond with the right resources.
As an example, we use AI and predictive analytics built into our claims system to flag when a claim might need a timely, targeted intervention. These triggers enable us to pull in clinical, behavioral health, return-to-work and other support in the moments when they can have the most impact on the claim’s outcome.
2. Adopt a more human-centric approach.
Injured workers want to feel seen, heard and supported — not reduced to a claim number and treated like a transaction. Managing claims with empathy builds trust, improves recovery and helps prevent legal escalation.
At Sedgwick, we train examiners to be more than technical experts. They’re coached to lead with empathy and respond with clarity. We also use in-claim surveys to understand how people are feeling throughout the process — so we can adjust in real time and make the experience more personal, responsive and human.
3. Communicate proactively and personally.
Injured workers shouldn’t have to chase down answers or wonder what’s next. When communication starts early — and feels relevant — it prevents confusion, reduces delays and lowers the chance of attorney involvement.
We reach out as soon as a claim is reported and stay connected in the way each injured worker prefers. That might include a welcome call that opens with a conversation about what happened — not a long list of intake questions — followed by weekly text updates. Every interaction, whether it’s by chat, email, call or text, is timely, thoughtful and shaped around how each injured worker wants to engage.
4. Use technology to power better experiences.
Technology is what makes smarter claims management, human-centric engagement and personalized communication possible and scalable. It helps organizations identify complexity, support fast decision-making and make important information accessible anytime, anywhere — something today’s workforce increasingly expects.
At Sedgwick, technology supports every part of the claims process. AI helps examiners flag complex claims, summarize documents and automate routine tasks. For injured workers, our self-service portal, mySedgwick, offers real-time access to claim details, chatbot support and customizable communication preferences. These tools help everyone navigate the process with ease and confidence.
Better strategies, better outcomes
Rising costs, shifting expectations and a more complex workforce are reshaping the claims landscape — making it more challenging to deliver fast, safe and effective recoveries and returns to work.
Delivering meaningful results starts with these four strategies:
- Identify complexity early and bring in the right support
- Lead with empathy and put people at the center of the process
- Communicate in ways that are proactive, personal and responsive
- Use technology to make the experience seamless — for everyone involved
Organizations that evolve their strategies — and focus on the person behind the claim — will be better equipped to keep pace with today’s challenges and deliver optimal outcomes.
