1. THE AGING WORKFORCE:
CHALLENGES AND OPPORTUNITIES
Americans are living and working longer. As
a result, older employees constitute a larger
segment of the workforce, particularly the Baby
Boomer generation who consistently state their
plans to work beyond the age of 65.
THIS MEANS THAT employers and workers’
compensation professionals must address growing
risks for injuries among these employees who are
graying at work and staying in the workforce past
traditional retirement age. In fact, according to the
US Department of Labor, Bureau of Labor Statistics,
older workers pose an increased risk for fatal work
injuries and require more time to return to work
following an injury than younger counterparts.
Existing health conditions, such as diabetes, are
already impacting workers in this age group. The
prevalence of co-morbidities increases with age;
they can be related to behaviors and lifestyle, or
simply result from pre-existing illnesses.
Compensability is another issue of the aging
workforce, posing challenges in determining how
much of an injury is actually work-related and how
much might be due to the effects of aging, or co-
morbidities associated with aging. In response
to the Affordable Care Act, there has been an
increase in shifting cases from group health to
workers’ compensation.1
Workers’ compensation
professionals must bring an even greater skill
and discernment to determine whether or not an
injury is compensable.
Finally, older workers have shown an increased
likelihood to use litigation to resolve workers’
compensation claims, further adding to the
potential cost – and complexity – of their claims.2
The aging of the workforce is one of the most significant trends to impact workers’
compensation over the next two decades, driving up both medical and indemnity
expenses and impacting the recovery time for injured workers. Workers’ compensation
professionals and executives need to understand this trend, its impact, and build on
how to optimize care and claim management for this population group.
Every day, 8,000 baby boomers
turn 65.3
Nearly 3 in 4 boomers will continue
to work beyond 65.4
79% of Americans ages 50+ state
that they plan to work full or part
time after ‘retirement’. 5
Between 1977 and 2007,
employment of workers 65 and over
increased 101%. These figures have
continued their upward trend and
are expected to continue over time.6

2. THE AGING WORKFORCE: CHALLENGES AND OPPORTUNITIES
The challenges posed by this growing workforce
age group must be addressed by workers’
compensation professionals – claims managers,
adjusters, nurse case managers, and enterprise
executives who will see the impact of older workers
on costs and productivity for years to come.
If these unique needs are not addressed, we
are likely to see rising costs of claims, increased
duration of time away from work resulting from
illness or injury, and decreased productivity of
these aging employees.
FOUR CHALLENGES PRESENTED BY AGING WORKERS
This brief will present insights on the effects of aging on the workforce, and present
recommendations for managing work-related injuries and illness for this growing
segment of the workforce.
There are four major issues to consider when planning care and claims management
strategies for older injured workers.
Diagnosis and Compensability
Establishing an accurate diagnosis for aging patients is often challenging due to preexisting
conditions and medications that interfere with the diagnostic process. For example, some
medications will interfere with the contrast levels that are shown and used for diagnosis on
CT-scans. For EMG tests, blood thinners can impact the results and must be stopped several
days prior to the testing. Identifying the right specialists during the diagnostic process will
allow for accurate diagnosis and, ultimately, more efficient treatment and case resolution.
Determining which injuries are covered by workers’ compensation and which are caused by
a person’s lifestyle, recreational activities or aging, can be challenging. It is important that
the right specialists and top performing doctors are selected as they are best equipped
to ensure that injury evaluation and treatment are appropriately categorized and billed,
ultimately saving money for workers’ compensation companies.
Longer Recovery Times
According to the Bureau of Labor and Statistics, older employees’ injuries are more severe
than those of younger workers. Claim severity for older workers (45-64) is more than 50
percent higher than younger employees for both indemnity and medical claims.
Older workers tend to have longer durations of work absences due to injuries or illness
and a higher incidence of work injuries overall, including falls, contact with objects and
overexertion. In fact, one in three people ages 65+ fall each year.8
And, older individuals are more adversely affected by the secondary effects of these
injuries. For example, some fractures, such as those to the hip, might result in forced
immobilization and surgery. This can then lead to joint stiffness and the enforced bedrest,
to pulmonary complications, embolism, disorientation and musculoskeletal weakness.
In fact, in a study of functionally independent patients who lived at home before a
fracture, 20 percent required institutional care beyond one year and 30 percent required
mechanical aids or assistance from personnel.11
1
2

3. Preventing Injury and Avoiding Re-injury
Aging workers are simply more prone to accident and injury, requiring that special
attention be paid to prevention, ergonomics, and careful management of re-entering the
workforce to avoid re-injury. Older workers can be more fragile and subject to re-injury.
Injured workers ages 55+ report a median of 12 lost days, twice the amount of lost work
days among injured workers ages 20-24. This means more lost-time, higher wages and
higher indemnity costs for older workers.12
Co-morbidities and Complications
Co-morbidities such as diabetes, osteoporosis and heart disease can directly influence
medical, therapy care and patient outcomes. Forty percent of adults ages 40 to 74 are
pre-diabetic.7
Proper identification and management of co-morbidities is critical to ensuring successful
recovery and workplace return among injured employees, particularly older workers.
Did You Know? Ninety percent of patients seen in physical therapy outpatient settings
have at least one medical co-morbidity and sixty percent have at least two.9
3
4
THE AGING WORKFORCE: CHALLENGES AND OPPORTUNITIES

4. THE AGING WORKFORCE: CHALLENGES AND OPPORTUNITIES
Eyes Occupations that require significant periods of time at a desk often put strain on
employees’ eyes. Conditions like macular degeneration, cataracts and weakened visual
accommodation become more common with age. These conditions can decrease worker
productivity and increase the time required to complete tasks on a computer or in projects
where vision is critical to performance.
Brain Memory loss, confusion and attention problems can all be signs that the aging brain
is beginning to have an impact on an employee’s work productivity and performance. If
not addressed, these signs can lead to significant on-the-job injuries and reduced ability
to complete tasks.
Ears With an aging workforce, there is an increase in claims related to hearing loss. This
trend can be extremely challenging for workers’ compensation because it can be difficult
to identify if the hearing loss is related to on-the-job tasks. Further, because hearing aids
do not have a set fee schedule, it is difficult for many companies to identify fair costs for
hearing aid devices.
Teeth and Jaw Old bridges, lack of treatment for existing conditions and dry mouth
that can lead to bone rotting will all impact the treatment approach when dealing
with a workers’ compensation claim – and should be accounted for when determining
compensability.
Muscles Most people experience some age-related loss in muscle size and strength,
which has a direct correlation to muscle loss, loss of strength and increase for fall risk. In
fact, by the age of 80, more than half of body’s muscle has been lost and nearly one-third
of this population will experience a fall requiring medical treatment.
Joints – Ankles, Wrists, Hips Weight bearing and movable joints are at the highest risk
for age-related degenerative changes that could increase a worker’s risk for a workplace
injury, like a fall, and can also lead to slower recovery rates.
Joints – Back, Shoulders, Knees Age-related conditions such as osteoporosis and
arthritis can increase the potential for workplace injuries related to the back, shoulders and
knees, while also creating complications and compensability. In jobs where overexertion or
repetitive strain are common, it is particularly important to understand if there are these
existing conditions that might increase a worker’s risk for injury to these areas.
Skin Skin breakdown is particularly common in aging workers as many older people
begin to shower less frequently and often work in desk jobs that require them to sit in the
same position each day for long hours. If not recognized and treated early, costs related
to skin breakdown in stages two or three can run workers’ compensation companies as
much as $80,000.
Vascular System Aging causes changes to the vascular system, including higher blood
pressure, stiffened arteries and diminished ability to regulate heart rate. These changes
can negatively impact an employee’s recovery time from illness or injury and increase
likelihood of a serious injury.
ANATOMY OF AN AGING WORKER13

5. THE AGING WORKFORCE: CHALLENGES AND OPPORTUNITIES
TIPS FOR MANAGING INJURIES & ILLNESS OF THE AGING WORKER
Diagnosis and Compensability
1. Seek Expertise to Evaluate Compensability.
Injuries can be influenced by or even caused
by the natural deterioration of aging. Examples
include hearing loss, pain, joint problems, dental
conditions and vision conditions. Specialized
expertise may be required to evaluate the older
injured worker to determine what the scope of
the actual work related injury is.
2. Engage High Performing Doctors. Studies have shown that high performing doctors, those
considered “top doctors” with extensive experience in a given specialty, produce improved medical
outcomes and, ultimately, lower indemnity costs in workers’ compensation claims.
Co-morbidities and Complications
3. Identify Co-Morbidities Right Away. Ninety percent of patients in the physical therapy outpatient
setting have at least one additional medical co-morbidity, such as diabetes, which can impact
a patient’s ability to quickly and adequately recover from an injury or illness14
. Addressing and
proactively managing co-morbidities allows for reduced lost work days and improved long-term
health for patients.
4. Adjust Treatment Plan Based on Medications. Many older injured workers are already taking a
number of medications that can impact their ability to work and, once injured, recover for a quick
return to work. Because of this, it is critical to address a patient’s current medications – and their
side effects – when determining appropriate additional prescriptions, designing a treatment plan
and identifying the types of tasks that can be completed once an employee returns to work.
Longer Recovery Times
5. Evaluate the Need for Long-Term Management of Conditions. For many older patients, recovery is
a process that requires ongoing management of a condition or regular therapy sessions. It is critical
that patients follow through on these appointments, continue using prescribed equipment for their
condition and maintain close contact with their physicians regarding any prescribed medications.
Proactive long-term management of a condition can lead to improved outcomes, lower overall
costs and fewer lost work days.
6. Evaluate a Patient’s Support System. Asking questions about a patient’s at-home support system
will help to ensure that a patient can be successful in the recovery process. Many older people have
lost their life companions and live alone, requiring additional home health care and transportation to/
from appointments. Some patients have family members who will help with managing medications
and ensuring that treatment plans are followed, while others might require more proactive care
from the care team.
By following these tips, workers’ compensation professionals can address the
pitfalls that might occur for a fast and safe recovery by an injured worker and
avoid complications and delays that can lengthen the claim and drive up costs.
With more high performing doctors
in its network than any other company,
One Call Care Management is dedicated
to finding the right specialists to treat
every patient’s condition – facilitating
every employee’s recovery and quick
return to the workplace.

6. THE AGING WORKFORCE: CHALLENGES AND OPPORTUNITIES
TIPS FOR MANAGING INJURIES & ILLNESS OF THE AGING WORKER
7. Utilize Clinical Guidelines. Guidelines should be used as a tool and goal for treatment utilization
trends to ensure that employees are best equipped for long-term success in their recovery.
Developing goals and proactively managing a treatment plan can help ensure that employees heal
quickly and adequately.
Preventing Injury and Re-injury
8. Recognize Risk Factors Early. Muscle weakness, lack of sleep, vision problems, confusion, agitation
or mental status changes, and changes in eating habits can all be signs that employees are at
increased risk for injury or illness. Recognizing these risk factors and helping employees or injured
workers to seek assistance early can help to identify problems before they become more serious.
9. Engage Workers in Active Health Management. Provide opportunities for injured workers to
become actively engaged in the management of their health. “Exercise prescriptions” can help
to provide tailored strength and health activities to meet each person’s needs and abilities.
Through encouraging improved balance, strength and functional abilities, employers and workers’
compensation professionals can help to prevent injury among employees and, for those already
injured, enable long-term healing of an injury.
For more information, contact
One Call Care Management
841 Prudential Drive | Suite 900 | Jacksonville, FL 32207
P: 800-848-1989 | www.onecallcm.com
One Call is the nation’s leading provider of specialized solutions to the workers’ compensation industry.
One Call’s solutions enable faster, more efficient and more cost-effective claims resolution with a focus on
injured workers’ needs across the continuum of care. One Call provides reliable, consistent connections
to care with expertise in high end diagnostics, physical therapy and transportation services, post-
discharge home care and durable medical equipment, dental and doctor specialty services, complex care
management, and the language services required for today’s multicultural workforce.
Resources
1. Workers’ Compensation Research Institute (WCRI).
http://www.wcrinet.org/media_release_1.29.15_conference.html
https://www.safetynational.com/conferencechronicles/impact-of-affordable-
care-act-on-workers-compensation-case-shifting/
2. Harbor Health Systems data.
3. American Association of Retired Persons (AARP).
http://www.aarp.org/personal-growth/transitions/boomers_65/
4. Public Risk, January 2013. Kevin Glenvvvnon, One Call Care Management.
The Aging Workforce: The Good, The Bad And The Expensive.
5. American Association of Retired Persons (AARP).
http://www.aarp.org/personal-growth/transitions/boomers_65/
6. Bureau of Labor Statistics. Spotlight on statistics: percent increase in
employment by age and sex, 1977-2007. 2008.
7. CBS News, “41 Million Have Pre-Diabetes.”
http://www.cbsnews.com/news/41-million-have-pre-diabetes/
8. U.S.andstategovernmentresearchers(CDC,BLSandseveralstateagencies).2009.
9. Align Networks data.
10. National Center for Health Statistics, Data warehouse in trends for health &
aging. Centers for Disease Control and Prevention, 2002-2003.
11. Dorland Health, “Supercharged Cost Drivers.”
http://www.dorlandhealth.com/dorland-health-articles/Supercharged-Cost-Drivers
12. U.S.andstategovernmentresearchers(CDC,BLSandseveralstateagencies).2009.
13. National Institute of Health. 2009. MedlinePlus: Winter 2007. 2: 1. Pages 10 – 13.
14. Align Networks data.