Most workers' comp risk management is reactive. After an accident, an investigation begins, but a better approach would be to identify risks and remediate them before any workers are injured. To do that, you need a way to organize data and spot trends. That’s a perfect use case for AI.
AI can slice-and-dice data with lightning speed, surfacing trends that can help businesses minimize injury risk and reduce workers’ comp costs. It can also detect questionable claims and ensure compliance with return-to-work requirements.
In small businesses with a single location, it’s easy to spot patterns in injury data. But when you have thousands of employees in multiple states, it’s much more challenging to connect the dots.
AI can monitor workplace injury data to identify patterns such as:
With the ability to cross-reference all of those data points and more, AI can quickly flag teams when it identifies a pattern or anomaly that requires human review.
Not every claim carries the same risk. Some resolve quickly and predictably. Others have the early markers of a long, expensive, or contested case, like comorbidities, delayed reporting, and ambiguous injury descriptions. AI can catch those markers early, flagging complex cases for review.
AI can also determine the course of action in cases that trigger eligibility for both workers’ comp and FMLA and notify the employee what documentation is required and when.
Multi-state businesses often have several independent medical examiners that certify workers’ comp claims. Unfortunately, some IMEs may act in their own best interest, certifying unnecessary, lengthy treatment plans for injured workers just so they can bill insurance. AI can easily spot suspicious certification patterns with specific IMEs, so businesses can take corrective action.
AI can help businesses document good-faith compliance efforts in the RTW process by logging every conversation, decision, and the data behind each decision. For example, Pulpstream—a leave management system with AI automation—scans the Job Accommodation Network to find and suggest appropriate accommodations for employees, which makes the whole process more objective than subjective.
AI doesn't make compliance determinations, and it doesn’t prevent every possible workplace risk. What it does do is give your team a better-informed starting point, and it extracts meaningful points from mountains of data that might otherwise go unnoticed.
If you're evaluating an AI-powered platform to help with workers' comp risk management, a few questions are worth asking before you commit to anything:
The answers will tell you more about how the technology works than any feature list will. You can also request a quick demo to see whether a platform is a good fit for your business.