Don’t mistake workers comp stability for the absence of risk

Why employers should pay attention to cumulative trauma claims and return-to-work outcomes

Many employers have benefited from a more predictable workers’ compensation environment than in other areas of commercial insurance in recent years. While property, auto and liability have faced significant market volatility, workers compensation has remained one of the more stable lines, supported by a long-term decline in workplace injuries and favorable loss ratios.

That stability, however, should not be mistaken for an absence of emerging risk.

In California, cumulative trauma (CT) claims are increasing rapidly, contributing to higher claim costs and putting pressure on workers’ compensation rates. The share of indemnity claims involving CT has nearly doubled over the past decade, contributing to an 8.7% premium rate increase in 2025, with projections pointing to another 10% increase later this year.

Many stakeholders are now asking whether what happens in California will remain isolated or eventually influence workers’ compensation claim trends, rates and loss ratios in other states. Historically, legislative and regulatory developments on the coasts move inward over time.

At the same time, broader challenges like medical inflation, healthcare provider shortages and the closure of rural healthcare facilities are making it harder for injured workers to access medical treatment. These trends have implications for claim costs, recovery times and return-to-work outcomes.

Many of these developments point to a common reality: workers’ compensation outcomes are heavily influenced by factors beyond the initial injury itself. As claims become more complex and recovery challenges increase, employers have an opportunity to play a more active role in supporting injured workers, improving return-to-work outcomes and managing claim costs.

Cumulative trauma claims present a different kind of challenge

Unlike a traditional workplace injury that stems from a single accident or incident, CT claims involve injuries or conditions that develop gradually over time and may be attributed to repetitive physical or mental stress. As a result, determining causation is usually far more complex.

With traumatic injuries, there is typically a specific event and injury date. CT claims often involve subjective conditions and symptoms that can make it difficult to distinguish between workplace activities, the normal aging process, pre-existing conditions and other non-work-related factors. If employment can be shown to have contributed to a condition—even by 1%—the claim may be deemed compensable.

CT claims are not the only sign that compensability standards are expanding. Presumptive laws covering certain cancers, heart and lung diseases, infectious diseases, and PTSD have increased workers’ compensation exposure for specific occupations by establishing that certain conditions are presumed work-related unless proven otherwise. CT claims can still be investigated and contested, but with such a low causation threshold, the practical burden on employers is significant either way.

The complexity of CT claims becomes particularly apparent during workforce reductions. Employers that have announced facility closures or layoffs have seen large numbers of CT claims filed shortly afterward. One California employer saw more than 80 legal applications following a reduction event after attorneys actively solicited former employees about whether they had pain they believed could be related to their work.

Staying connected to your employees can improve recovery outcomes

Employers can have a significant impact on what happens after an indemnity claim is filed. One of the most important steps employers can take is to help injured employees stay connected to their work and organization.

For example, transitional programs help employees focus on what they can do rather than what they cannot. Whether through modified-duty assignments or community-based programs, staying active, engaged and productive can reinforce an individual’s capabilities and help build confidence during the recovery process.

When workers retain a sense of connection with their employer and profession, they are often less worried about job security, financial security and their ability to return to normalcy. Ultimately, less fear can reduce the likelihood of litigation and the time away from work.

Preparing for a more complex claims environment

Whether or not cumulative trauma trends spread beyond California, the issue highlights the importance of strong workplace processes and documentation.

Employers should prioritize open communication and trust with employees and ensure injury reporting procedures and personnel records are thorough and current. This becomes especially important before layoffs or facility closures, when CT claims are most likely to spike. Exit interviews, documented job duty descriptions and injury logs give employers and their claims partners the foundation to fairly evaluate whether a condition is work-related or tied to pre-existing factors and the normal aging process.

Employers should also view workers’ compensation as part of a broader risk management strategy. Strong partnerships with brokers, insurers, attorneys and loss control professionals can help organizations identify emerging exposures and respond proactively. In many organizations, attention is understandably focused on risks such as property, liability, cyber or auto—but California’s experience serves as a reminder that workers compensation exposures can evolve quickly and deserve the same level of attention.

Jennifer Page – Director Workers Compensation Claims

Jennifer Page is the Director of Workers Compensation Claims for Sentry Insurance where she leads the western region including eight jurisdictions including the state of CA which represents almost 15% of Sentry’s overall workers compensation total claim volume. Jennifer has been at Sentry since 2000.

She holds a bachelor’s degree from the University of Wisconsin – Stevens Point with disciples in Business, Marketing and Public Relations.