September 4, 2025
(Original at Workers’ Compensation Institute, Orlando, Florida, August 18, 2025)
Description
Artificial intelligence (AI) is revolutionizing workers’ compensation by transforming how claims data, medical records, and interviews are obtained, analyzed, and reported. AI-driven data extraction enhances efficiency, improves outcomes, and optimizes claims management. Through advanced data mining and other approaches, AI enables more effective decision-making in areas such as medical care, claim management, causation, impairment, and work ability. AI also plays a key role in structuring and analyzing medical records, extracting critical information, and even conducting interviews with greater accuracy, comprehensiveness, and empathy than humans. By combining AI-driven insights with human oversight, organizations can streamline processes while ensuring ethical and compliant decision-making. In this session, highly experienced panelists will explore real-world applications of AI in the workers’ compensation field, demonstrating its value while addressing key ethical considerations and emphasizing the importance of human accountability in AI-driven processes.
Speakers
Chris Brigham
President, Brigham and Associates, Inc.
chris@chrisbrigham
Adam Fisher
Chief Data Officer, Sedgwick
adam.fisher@sedgwick.com
Itay Mishan
Chief Technology Officer, Wisedocs
itay@wisedocs.com
Recording of Presentation
Presentation (Slides)
Guidance
1. Learn and Experiment — Wisely
Physicians should approach AI tools with curiosity but also with discernment. Exploring multiple LLMs (e.g., ChatGPT-5, Claude Sonnet 4) and AI platforms (e.g., Poe) provides valuable exposure to different strengths and weaknesses. AI agents that perform multi-step reasoning may also accelerate workflows. However, physicians must remain cautious—AI is a support tool, not a replacement for clinical judgment or medico-legal expertise.
2. Prioritize Security and Confidentiality
The medico-legal setting involves sensitive personal health information (PHI). Physicians must ensure:
- Vendor safeguards: Select platforms that offer Business Associate Agreements (BAA) and adhere to zero-retention policies, preventing permanent storage of PHI.
- Redaction/anonymization: Remove identifiable details before submitting data to AI systems lacking healthcare-grade security.
- Regulatory compliance: Stay informed on applicable HIPAA, GDPR, and jurisdictional medico-legal requirements to prevent inadvertent breaches.
3. Develop Effective Prompts
The quality of AI-generated output depends on the clarity of the input. Physicians should practice prompt engineering, which involves crafting structured, detailed instructions to achieve reliable results. Effective strategies include:
- Clearly defining the task (e.g., “Summarize medical chronology for court report in narrative format”).
- Specifying tone and structure appropriate for medico-legal documentation.
- Iteratively refining prompts and, where appropriate, using AI itself to suggest improvements.
4. Enhance Accuracy with Knowledge Integration
To minimize hallucination and strengthen medico-legal rigor, physicians should supplement AI with domain-specific knowledge:
- Local knowledge bases: Integrate prior case reports, jurisdictional statutes, and AMA Guides references.
- Retrieval Augmented Generation (RAG): Connect AI tools to curated reference sets, ensuring outputs are contextually grounded.
- Human oversight: Every AI-assisted draft must undergo physician review for factual accuracy, legal defensibility, and clinical precision.
5. Maintain Professional Judgment
AI is a powerful assistant, but cannot substitute for physician expertise. Physicians must:
- Recognize that AI outputs are drafting aids, not medical or legal conclusions.
- Take responsibility for ensuring that all opinions, ratings, and causation analyses reflect independent medical reasoning.
- Document clearly how the physician’s analysis, not the AI system, formed the final medico-legal opinion.
Conclusion
Artificial Intelligence can significantly streamline medico-legal documentation, but its safe adoption requires careful attention to security, accuracy, and accountability. By experimenting wisely, safeguarding patient confidentiality, mastering prompt development, integrating contextual knowledge, and exercising professional judgment, physicians can harness AI to improve efficiency while upholding the highest medico-legal standards.
