Ryan Smith is the Senior Solutions Advisor for True Insurtech Solutions
The American workforce doesn’t look the way it did ten years ago. It doesn’t look the way it did five years ago. The people doing the work are older. They’re in different industries. They’re in different states. And the way they get injured on the job is shifting along with them.
At AIS 2026, NCCI is dedicating two consecutive sessions to this theme, and it’s one of the more strategically important pairings on the agenda. First, NCCI Senior Economist Patrick Coate will present “Demographic Forces Shaping Workplace Risk,” examining how population shifts, aging demographics, migration patterns, and labor force participation trends are influencing injury patterns. Then, NCCI Practice Leader and Senior Actuary Paul Hendrick will pick up where Coate leaves off with “From Demographics to Claims: Turning Data Into Insights,” connecting workforce characteristics to actual claim experience and exploring where state-level trends align with or diverge from the national picture.
NCCI itself has signaled the importance of this pairing. Coate described the sessions as essential to understanding how the workforce’s evolution connects to risk, while Hendrick noted that his session will use NCCI data to connect experience to outcomes and illustrate the potential implications for workers’ compensation.
That’s the kind of data-to-action pipeline that makes these sessions worth building strategy around. Here’s what we know going in.
The Aging Workforce Is a Current Problem
The single most significant demographic trend in the American labor force is the rising number and share of workers age 65 and older. NCCI’s research has tracked this for years, and the trajectory is clear: the U.S. labor force age 65 and older is projected to grow 55% from 2019 to 2029, reaching nearly 10% of the projected workforce. Among prime-age workers, growth is concentrated in the 35-44 cohort, while the 55-64 group is one of the few age bands with both a projected population decline and a labor force decline.
For workers’ compensation, this matters for a specific reason. While injury frequency has been on a decades-long decline across most age groups, NCCI’s data shows that work injury rates for workers age 65 and older have increased every year since 2015. That’s a direct countertrend to the overall frequency story. The age group that’s growing the fastest is also the one where injury rates are moving in the wrong direction.
And the severity picture is even more pronounced. Older workers don’t just get injured at higher rates relative to their trend. They take longer to recover. NCCI’s research shows that days away from work increase with age within injury types, particularly for falls, slips, and trips. Most of that difference comes from longer recovery periods within the same injury category, not from older workers sustaining fundamentally different types of injuries. Co-morbid conditions like diabetes and degenerative joint disease compound the issue, slowing healing and increasing the overall cost per claim.
For anyone managing a claims operation or underwriting a book of business, the implication is straightforward. The demographic tailwind that has helped drive frequency down for decades is shifting. As the workforce ages, the mix of risk is changing. And the claims that do come in from older workers are, on average, more expensive and longer-duration.
The New Hires Problem Is Also a Demographics Story
Previously we touched on the frequency upside of a slower hiring environment: fewer new workers means fewer short-tenured workers in that elevated-risk, first-year-on-the-job category. NCCI’s data indicates that workers in their first year of employment account for an estimated 35% to 43% of work injuries.
But tenure effects don’t exist independently of demographics. They interact with them. The age, education level, and industry of new hires all influence how that first-year risk manifests. A 22-year-old entering a construction job has a very different risk profile than a 55-year-old returning to the workforce in healthcare after a career change. Both are new to their roles. Both carry that elevated first-year risk. But the nature of the injuries they’re likely to sustain, the expected duration of their claims, and the medical costs involved are fundamentally different.
NCCI’s earlier research on workforce demographics found that younger workers are getting injured less often than their older peers, a major shift from historical patterns where youth was strongly correlated with higher frequency. The gender gap in frequency has also narrowed, driven by injury rates falling faster for men than for women. And critically, NCCI found that the overall frequency decline is driven mainly by lower incidence rates for all workers, not by demographic shifts in the composition of the workforce. In other words, workplaces are genuinely getting safer for most people. But the exceptions to that trend are where the strategic risk lives.
Where the Work Is Happening Matters as Much as Who’s Doing It
From March 2025 to March 2026, healthcare and social assistance added 680,500 jobs while overall payroll growth slowed to a near-standstill, with healthcare and social assistance accounting for the lion’s share of net hiring.
That kind of employment concentration has direct implications for injury patterns and claim mix. Healthcare workers face specific injury risks: patient handling injuries, needlestick exposures, workplace violence, and the cumulative physical demands of shift-based work. NCCI’s AIS 2025 data showed that despite pandemic disruptions, healthcare claim frequency generally declined from 2015 to 2023, driven by a nearly 30 percentage point reduction in strain-related injuries. That’s meaningful progress. But healthcare is also the sector absorbing the newest workers, and new workers carry higher frequency risk regardless of industry.
The industry-level picture gets more complicated from there. Restaurant claim frequency declined in 2022 and 2023, potentially driven by automation. But private education has seen rising claim frequency, primarily from “struck or injured by” claims linked to workplace violence. Remote work continues to suppress office-worker frequency. And motor vehicle accidents remain the leading cause of workplace fatalities, with frequency stubbornly resistant to the broader declining trend.
The question Coate and Hendrick will be exploring at AIS 2026 is how these industry-level patterns interact with demographic shifts. If the healthcare sector is absorbing most of the new employment, and that employment includes an aging workforce with longer recovery times, what does that mean for the medical severity trend in workers’ comp? If migration patterns are shifting the geographic distribution of the workforce, what does that mean for state-level claim experience?
Migration, Geography, and State-Level Divergence
One dimension of the demographic conversation that’s often underappreciated in workers’ comp is internal migration. People are moving. And where they’re moving to changes the risk landscape for the states they enter.
Sun Belt states have been absorbing significant population inflows for years. States like Texas, Florida, Tennessee, and the Carolinas have seen sustained net in-migration, while many Northeastern and Midwestern states have experienced outflows. This reshapes the workforce composition in both the origin and destination states.
For carriers and administrators operating across multiple states, this is where the demographic story connects directly to the book-of-business story. The risk profile of a given state’s workforce is not static. It shifts as people move, as industries expand or contract, and as the age distribution of the working population evolves. The state-level claim patterns that Hendrick will be exploring at AIS 2026 are shaped by these demographic undercurrents.
The Severity Connection
The demographic conversation isn’t just about who gets hurt or how often. It’s about what happens after the injury. And that’s where the cost implications get real.
Older workers have longer recovery periods. Workers in physically demanding industries sustain more complex injuries. Claims involving comorbidities cost more and take longer to resolve. And as the workforce ages and concentrates in sectors like healthcare and construction, the mix of claims is shifting toward higher complexity.
NCCI’s 2025 State of the Line report flagged medical claim severity up 6% in 2024, with utilization and shifts in medical practice cited as key drivers. As the demographic profile of the workforce shifts toward older, potentially more comorbid workers in physically demanding industries, the tail of the severity distribution is likely to get heavier.
This doesn’t mean severity will spike overnight. But it does mean that the composition of claims is changing in ways that aggregate severity numbers can mask. Understanding the demographic drivers behind severity trends is essential for accurate reserving, informed underwriting, and effective claims management.
What I’ll Be Watching at AIS 2026
The Coate and Hendrick sessions are a paired arc, and I’ll be watching for specific things in each:
From Coate: How is the 65+ workforce growth tracking against projections? Are migration patterns creating visible shifts in state-level workforce composition? What’s happening with labor force participation rates across age groups and geographies?
From Hendrick: Where are state-level claim trends diverging most sharply from national patterns? Can we see the aging workforce effect showing up in severity data at the state level? How do industry-specific injury patterns interact with demographic shifts in the NCCI data?
Across both sessions: The handoff between demographic context and claims data is where the actionable insight lives. I’ll be listening for the specific connections between workforce shifts and claim outcomes that carriers and administrators can translate into operational decisions.
Why This Should Change How You Think About Your Book
If you’re managing a workers’ compensation operation, the demographic data presented at AIS 2026 should inform decisions across the business.
On the underwriting side, understanding how the age distribution and industry mix of the workforce is shifting by state helps you price risk more accurately and target growth more effectively. For claims professionals, recognizing that an aging workforce with longer recovery times and more comorbidities changes the expected duration and cost of claims helps you allocate resources where they’ll have the most impact. And for those managing technology and data, having access to solutions that can segment and analyze your book along demographic dimensions, and surface emerging patterns before they become surprises, turns this kind of intelligence into competitive advantage.
The organizations that treat demographics as background noise will get surprised by shifting loss patterns. The ones that build it into their strategic planning will be better positioned to manage what’s coming.
Let’s Talk at AIS
I’ll be at AIS 2026 in Orlando May 11-13. Whether you’re navigating multi-state complexity, evaluating your technology platform strategy, or thinking about how to build better analytical capability into your operations, I’d welcome the conversation.
