Blog

AI and the Impact on Workers' Comp - RMC Group

Written by RMC Group | Jun 26, 2023 2:37:51 PM

In recent years the use of artificial intelligence (AI) has exploded.  AI encompasses machines, computer systems, and other devices that can simulate human intelligence processes. In other words, this technology can perform a variety of cognitive functions typically associated with the human mind, such as observing, learning, reasoning, interacting with surroundings, problem-solving, and engaging in creative activities.

Applications of AI technology are widespread.  However, some of the most common include computer vision solutions (e.g., drones), natural language processing systems (e.g., chatbots), and predictive and prescriptive analytics engines (e.g., mobile applications). This technology has the potential to change many aspects of the workplace, especially as it pertains to preventing and managing occupational injuries.

As a result, implementing AI could have a significant impact on organizations’ workers’ compensation programs. This article provides more information on the way that AI technology can be leveraged to address employee injuries, bolster recovery processes, and minimize overall workers’ compensation expenses.

Addressing Employee Injuries

When employees get injured on the job, prompt treatment is critical. Fortunately, AI technology can quickly identify when workplace incidents and related injuries occur (e.g., computer vision tools detecting an employee slipping and falling on the floor), paving the way for speedy response measures. Specifically, this technology can help organizations address employee injuries in the following ways:

Providing fast diagnoses—When workplace incidents occur, AI technology can utilize advanced imaging and scanning techniques to diagnose employees’ injuries at rapid rates, allowing workers to get the medical assistance they need and move forward with treatment as soon as possible.

Improving assessment accuracy—AI technology is equipped with immense data analysis capabilities. As a result, it can analyze complex medical information quickly and accurately and can often provide greater insight into an injured employee’s condition than a doctor.  This can lead to more accurate medical assessments and better treatment.

Creating personalized treatment plans—Once an employee’s injury has been diagnosed and assessed, it is important that they get proper treatment. AI technology is capable of reviewing an employee’s unique medical history and injury characteristics to generate a customized treatment plan that caters to their individual needs. This can help expedite and enhance recovery outcomes.

Bolstering Recovery Processes

In addition to helping organizations address employee injuries, AI technology can prove valuable to workers’ recovery journeys, equipping them with the resources and support needed to regain their health and resume their positions in a timely manner. The following are ways in which AI can help the recovery process:

Offering real-time monitoring—By using wearable devices and sensors (e.g., smartwatches), AI technology can assess injured employees in real time and monitor their recovery progress, providing doctors with immediate feedback so they can respond accordingly.

Adjusting treatment plans as needed—By monitoring an injured employee’s recovery progress and using the experience of other patients who have suffered similar injuries, AI technology can revise individualized treatment plans and deliver researched recommendations on rehabilitation techniques that are most effective for a worker’ specific injury.

Implementing advanced rehabilitation solutions—AI technology can optimize an injured employee’s recovery outcome by automating certain rehabilitation components. For example, workers recovering from spinal cord injuries can use AI-powered exoskeletons, which are wearable robotic devices that might enable them to regain their balance, coordination, strength and—in some cases—ability to walk at faster rates. Additionally, employees recovering from amputation injuries can leverage AI-embedded systems to obtain 3D designs for prosthetic parts or receive adaptive tissue and muscle assistance, thus helping them restore their mobility.

Minimizing Workers’ Compensation Expenses

AI technology can help organizations reduce their total workers’ compensation expenses by both preventing and mitigating potential claims. This technology can cut costs in the following ways:

Investigating claims—AI technology can utilize sophisticated coding capabilities and data analysis strategies to review workers’ compensation claims and conduct in-depth investigations of associated occupational injuries. From there, AI can help identify key causes of workplace incidents, distinguish primary diagnoses for claims, detect comorbidities among injured employees and determine treatment-related cost drivers. Based on these results, AI technology can highlight incident trends and injury patterns, offering guidance to help organizations prevent similar claims in the future and make more cost-effective decisions if such claims arise.

Selecting ideal providers—Medical services and treatment options can vary between health care providers. While claims adjusters may suggest certain doctors for treating injured employees, not all providers offer the highest-quality care. AI technology relies on historical data and predictive analytics to recommend top-performing providers for injured workers’ particular situations, allowing them to receive the best possible care and experience optimal recovery outcomes. According to the latest industry data, using AI technology to direct injured employees to high-quality providers can help organizations reduce their workers’ compensation claims costs by up to 45%.

Detecting treatment anomalies— By analyzing treatment records, AI technology can recognize potential anomalies, such as procedures or medications administered for injuries that do not usually require these types of services. This can help injured employees avoid unnecessary treatment and protect organizations from incurring additional workers’ compensation expenses associated with such services.

Reducing claim complexity—Industry research shows that as much as 80% of workers’ compensation claims involve minor injuries that do not require treatment from medical specialists. Yet, some organizations direct injured employees to specialists for most occupational ailments. AI technology can enable organizations to easily determine whether specialist treatment is necessary, helping them save time and money during the recovery process and prevent workers’ compensation claims from becoming overly expensive.

Conclusion

AI technology could make all the difference in helping organizations improve their workers’ compensation programs by promoting greater injury detection and response measures, advanced recovery methods and cost-effective claims management protocols. Further, this technology can give organizations the resources needed to limit employee injuries and put a stop to associated workers’ compensation claims before they even begin.

AI technology can be costly to implement and continues to evolve, carrying the potential for unknown risks. For instance, AI-related liability issues and data privacy exposures have become rising concerns across the employment landscape.

Organizations should consult trusted experts (e.g., legal counsel and insurance professionals) and assess their specific workers’ compensation program needs before adopting AI technology. Contact RMC Group today for additional workers’ compensation resources at 239-298-8210 or rmc@rmcgp.com.

This article is not intended to be exhaustive, nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice. © 2023 Zywave, Inc. All rights reserved.