Sykes: What Workers' Comp Adjusters Are Building to Fill the Coordination Gap

Monday, April 13, 2026 | 0

“If I have to follow up with just two of these people per claim, it’s incredibly time-consuming and not feasible.”

Cameron Sykes

That’s a senior adjuster describing a litigated claim with six parties: injured worker, applicant attorney, defense attorney, adjuster, employer and a fronting employer above them. Not a catastrophic claim. Not an outlier. A normal file.

This is what early-stage claim-handling looks like for a significant portion of the workers’ compensation workforce — and it is the starting point for a pattern that keeps surfacing across geographies, experience levels and claim types.

The first two weeks are the hardest to manage

In surveys and interviews conducted with adjusters and supervisors across California, Texas, Florida, Alabama and multi-state environments, the first seven to 14 days of a new claim emerged as a consistent pressure point. The claims systems in use — Guidewire, Origami Risk, Mitchell and others — were not the source of frustration. The frustration lives in the coordination layer that sits on top of them: tracking who has been contacted, what information is still missing, who is responsible for responding, and for how long.

Across respondents, tracking missing information and follow-ups were the most consistently elevated pain points in the claim setup process — rated at the highest levels of difficulty by a consistent pattern of claims professionals surveyed, regardless of state, experience level or claim type. The open-text responses told the same story in different words.

“Chasing down missing employer and employee info or statements.”

“Tracking down claim details for claims where employers do not properly complete the FROI.”

“Nonresponsiveness from client or employee.”

The impact, as one supervisor put it, simply “[d]elays claims moving forward.”

The gap that sits outside the adjuster’s control

Several respondents pointed to a root cause that sits outside the adjuster’s control entirely. One adjuster noted that their book of business skews toward small and medium-sized employers — businesses that often do not have dedicated HR functions. When a claim comes in, the person responsible for responding may be a manager, an owner or someone doing HR as a secondary duty. They are not always equipped to provide wage records, injury details or employee contact information on a timeline that matches the adjuster’s.

A senior adjuster handling multi-state claims noted that when files are submitted through managing agents, basic claimant data — phone numbers, Social Security numbers, employment details — frequently does not arrive with the file. The adjuster absorbs that gap.

High employee turnover compounds this. One respondent cited it as a primary driver of incomplete first reports of injury: The person who would have had the information is no longer at the company.

When the system doesn’t solve it

Perhaps the most telling signal in this research is not what adjusters are struggling with; it is what they have done about it.

Independently, across different organizations and different states, experienced adjusters have built personal workaround systems to manage the coordination gap that their claims platforms do not address. Custom checklists. Personal templates. Spreadsheets running in parallel to enterprise systems. One respondent named “templates and workflows” as the tool that makes claim setup faster — tools they built themselves.

One respondent put it plainly: Word docs and spreadsheets remain the most practical solution available for tracking who has been contacted and what is still outstanding on a new claim.

A consistent pattern across respondents was that few had encountered a tool that meaningfully addressed this coordination problem, and yet a clear interest in a better solution emerged throughout the research. What that solution looks like remains an open question.

When experienced professionals, working independently across different organizations, arrive at the same DIY solution to the same problem, it suggests the gap is real, consistent and not being addressed by existing tools. It also suggests that the people who know this work best have already thought carefully about what a better approach would need to do.

A question worth putting to the industry

This research is ongoing and being expanded across a broader population of claims professionals. The patterns described here will continue to be tested. But the consistency of what has surfaced so far — across states, roles and experience levels — makes one question difficult to set aside: If experienced adjusters are independently building the same workaround tools to manage the same coordination problem, what does that say about the support structures currently available to them?

Not about the claims systems themselves — those are doing what they were built to do. But rather, the layer of work that happens between the system and the 10 parties on the other end of a new claim. The calls that need to be made. The information that needs to be collected. The follow-ups that need to be tracked until someone responds.

What is clear from early research is that the consequences of poor coordination at claim opening do not stay contained to the first two weeks. They compound — in delayed investigations, incomplete handoffs and claims that arrive at later stages of the lifecycle already behind.

Adjusters have been solving this on their own for a long time. The question is whether the industry believes they should have to.

Cameron Sykes is an AWCP member and independent researcher conducting ongoing discovery into workers’ compensation claims workflow across multiple states. This summary draws on structured surveys and interviews with active claims professionals, all of whom are kept anonymous. He welcomes conversation with claims professionals who have a perspective on what’s described here — especially those who think it misses something. Connect on LinkedIn, here.