Winter 2025/2026

This special edition of RxInformer focuses on claims complexity in its many forms, exploring various low-volume high-cost topics, such as mega claims, occupational cancer, degenerative conditions, Long COVID, and more.


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Policy

State of the Nation

Sandy Shtab, VP of Industry and State Affairs, shares policy perspectives.

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Claim Complexities

Current State of Complex Claims in Workers’ Comp

Statistics from recent studies across the industry shed light on complex claims in workers' compensation.

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Claim Complexities

Wear and Tear: A Breakdown of Degenerative Comorbid Conditions

With the workforce growing older, degenerative conditions may have growing impact on claims

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Claim Complexities

Creeping Costs: The Rise of Mega Claims in Workers’ Compensation

A small percentage of claims are driving the majority of costs in workers’ comp. What are these “mega claims” and how can we mitigate them?

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Claim Complexities

The Cost of Exposure: How Occupational Cancer Impacts Workers’ Compensation

While the global cancer burden continues to rise, the risk and impact of occupational cancers can vary significantly depending on the nature of the exposure and the affected workforce. For payers who are impacted, the costs can be substantial.

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Claim Complexities

In the Long Run: How Long COVID Impacts Workers’ Comp

While severe cases are less common, they greatly impact costs, recovery, and return to work.

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Claim Complexities

Common Exceptions: The Rising Incidence of Complex Claims in Workers’ Compensation

More complex and costly claims have become a persistent issue in workers’ compensation. See what drives longer claim duration and higher costs and how to mitigate risk factors.

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RxInformer

Since 2010, the semi-annual RxInformer clinical journal has been a trusted source of timely information and guidance for workers’ comp payers on how best to manage the care of injured worker claimants and plan for the challenges that lay ahead. The publication is an important part of Healthesystems’ proactive approach to advocating for quality care of injured workers while managing the costs associated with treatment.