What Every Case Manager Should Know About RTW Technology

For years, return-to-work decisions were driven by experience, instinct, and a lot of time-consuming guesswork. The case manager has had to make tough calls with limited data and delayed updates in both return-to-work planning and medical case management. That’s starting to change.

A new wave of technology is reshaping medical workflows. AI, real-time recovery data, and automation are giving the case manager clearer insight into risk, progress, and readiness, transforming how medical case management is delivered.

We’re entering a new era of return-to-work, one that’s faster, smarter, and more personalized, without losing the human judgment that makes the case manager role so critical.

AI Claims Triage and Risk Detection

AI claims triage and risk detection refers to the use of machine learning and predictive analytics to automatically scan injury reports, medical records, and claim history to identify which cases are most likely to become complex, expensive, or delayed.

Instead of relying solely on adjuster experience and manual file reviews, these systems evaluate thousands of data points in real time to prioritize claims that need early case manager involvement and more proactive medical case management.

Research from McKinsey & Company shows that AI-driven triage improves identification of high-risk claims by 40–60%, giving the case manager visibility into complications long before they surface.

Together, these tools remove much of the guesswork. The case manager doesn’t have to wait for a red flag; they’re alerted proactively, enabling earlier intervention and more strategic medical case management.

The Rise of Wearable Devices

Wearable devices are changing how the case manager understands real-world recovery by turning day-to-day body data into clear, actionable insights. These devices track key recovery metrics such as:

• Oura Ring – Sleep quality, recovery readiness, and heart rate variability.
• WHOOP Strap – Strain, recovery capacity, and cardiovascular load.
• Apple Watch – Movement, heart rhythm, fall detection, and mobility signals.

Wearable technology has become one of the most powerful tools supporting modern medical case management. These tools help the case manager make better decisions about recovery and return-to-work readiness.

According to the Journal of Orthopaedic & Sports Physical Therapy, sleep patterns, heart rate variability, and activity levels can predict recovery timelines with 80–90% accuracy. This allows the case manager to monitor progress in real time rather than relying only on office visits and self-reporting.

These metrics are supported by validation studies showing 90%+ reliability in HRV markers collected by wearables like Oura and WHOOP.

Patient engagement is also improving. Digital rehab platforms dramatically increase adherence, with patients completing three times more exercises. Virtual PT programs can reduce recovery time by up to 30%, giving stronger visibility inside the medical case management process.

Adoption is accelerating. One in three U.S. adults uses a health-tracking wearable, with adoption expected to reach 50% by 2028. For the case manager, this means fewer blind spots and more reliable data inside medical case management workflows.

Reduced Administrative Burden for the Case Manager

Even highly skilled professionals spend a large portion of their day on administrative work. According to the Case Management Society of America, documentation, file review, and communication can consume 40–50% of a case manager’s workload, limiting the time available for direct patient support and medical case management strategy.

Generative AI is changing this. Automated summarization tools are reducing record-review time by up to 70%, allowing the case manager to spend more time coordinating care and strengthening medical case management outcomes.

Instead of sorting through hundreds of pages of records, the case manager can focus on clinical judgment, worker advocacy, and proactive coordination, the human core of strong medical case management.

What This New Era Means for the Case Manager

The role of case managers isn’t disappearing; it’s getting more strategic. With better data, real-time insights, and smarter tools, the case manager is shifting from reactive administrator to proactive clinical problem-solver.

Return-to-work plans are becoming more personalized and adaptive, adjusting to real-world recovery data instead of static timelines. Employers and carriers gain more predictable outcomes, while injured workers experience a more supportive, data-guided recovery journey.

For the case manager, this new era of return-to-work technology means clearer visibility, stronger decision-making, and more time to focus on what matters most: guiding safe, sustainable recoveries.

Explore how our medical case management solutions support smarter, faster RTW outcomes.

Check out our sources:

Accenture. Transforming claims and underwriting with AI. Accenture, 2022. Transforming Claims and Underwriting with AI | Accenture

Deloitte. Insurance Industry Outlook. Deloitte Insights, 2022. Deloitte: 2022 insurance industry outlook | Insurtech Insights

Lee, Alan C., et al. Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association (CPG+). American Physical Therapy Association, 21 Mar. 2024, https://www.apta.org/patient-care/evidence-based-practice-resources/cpgs/telerehabilitation-pt-practice-apta-cpg

McKinsey & Company. Insurance 2030: The Impact of AI and Automation on Claims Management. McKinsey & Company, 2021. Insurance 2030—The impact of AI on the future of insurance | McKinsey

National Heart, Lung, and Blood Institute. Study reveals wearable device trends among U.S. adults. 15 June 2023, www.nhlbi.nih.gov/news/2023/study-reveals-wearable-device-trends-among-us-adults