Decision support. ChironAI drafts the regulatory reasoning described on this page end to end. The treating physician reviews the reasoning, edits it, and attests before anything reaches a payer, an attorney, or the chart. ChironAI does not make a regulatory clearance claim; see Disclosures.

ChironAI OMHow it works

The regulatory reasoning, end to end.

This is the machine, opened up. A California workers’-comp determination is not one AI call — it is a pipeline: Chiron reads the whole case, convenes the specialists the case actually needs, grounds every claim in a real guideline document, hands the numbers that must be exact to code that cannot drift, argues with itself before anyone else sees the draft, and stops at a physician’s signature. Agentic, not autonomous: the system takes initiative at every step below except the two that matter most — the number, and the decision.

The pipelineSeven steps, one signature

What happens between the visit and the signature.

  1. 01

    One working record

    Chiron reads the whole claim as a single continuous record, not eleven separate tools.

  2. 02

    The Round Table convenes

    The right specialist Digital Employees join the case — gated by the case itself, not by a checklist.

  3. 03

    Grounded in the guidelines

    24 authentic California DWC MTUS/ACOEM documents, retrieved and cited, with a hard guardrail on every citation.

  4. 04

    The exact part runs as code

    PDRS, the §4664 offset, and every statutory deadline run as deterministic engines that override the AI on the number.

  5. 05

    It argues with itself first

    Chain-of-Verification: initial answer, adversarial self-questioning, revised final — before a physician sees it.

  6. 06

    The physician attests

    Review, edit, sign. Nothing reaches a payer, an attorney, or the chart without it — enforced server-side.

  7. 07

    Sealed and checkable

    SHA-256 binds the signature to the exact document. Anyone holding it can verify it hasn’t been altered.

Step 01One working record

Chiron reads the case, not eleven separate systems.

A California WC claim is a chain of statutes, and most systems treat each link as its own module with its own data entry. Chiron treats the claim as one working record from intake to closure: eligibility and §3600 classification and MPN routing, AOE/COE causation, MTUS/ACOEM-aligned treatment, UR and the RFA under §4610, IMR under §4610.5, the P&S/MMI determination, impairment and apportionment under §§4663–4664, the QME/AME process under §4062, billing and the pay clock under §4603.2, and the defensible record through settlement or closure under §5410.

Because it is one record, the causation finding a physician wrote in month one is still there, unedited, when the impairment rating is computed in month eight — and the reasoning that produced it is still inspectable. One Digital Employee, one working record, one signature standard, across 40 backend modules running in production today.

Step 02The Round Table

It convenes the specialists the case actually needs.

Chiron leads every case on the medical reasoning. Issac assesses utilization-review denial risk on every case, no exceptions. Justine convenes when the case raises apportionment or mixed causation. Eli convenes when there is a billing dispute. Theo — the bias-and-fairness reviewer — opens automatically whenever Chiron’s own confidence lands below a 70% threshold, with no one having to request it. The Round Table runs its consultations in parallel and degrades gracefully if a specialist can’t reach a conclusion on the record available.

ChironAI™ OMRound Table convened

Must review before final

Decision-support output. Clinician review and attestation required before this content is signed into the chart.

ChironMedical causation leadLead

Confidence: 66% — below the 70% review threshold, so the ethics review below opened without a request.

  • JustineLegal-evidence framingConsulted

    Consulted because the case raises apportionment.

  • TheoBias and fairness reviewConsulted

    Consulted because lead confidence is below the 70% review threshold.

  • IssacUtilization-review / IMR riskConsulted

    Consulted on every case.

  • EliFinancial / OMFS exposureNot consulted

    Consulted only when a billing dispute is present - not triggered here.

Case WC-2026-04812 — confidence-gated consultationIllustrative — representative of product UI. Synthetic case data; not from any real patient.
Step 03Grounded in the guidelines

Every recommendation traces to a document, not a memorized pattern.

The reasoner retrieves against 24 authentic California DWC MTUS/ACOEM guideline documents, kept current, rather than reciting a treatment guideline from memory. Ask the Case — the platform’s citation-verified retrieval surface — answers only from the case record plus that guideline corpus, with an inline citation on every claim. A hard, code-level guardrail deletes any citation the model didn’t actually retrieve, so a citation on the screen is a citation that was actually fetched, not a plausible-looking reference. An ICD-10 hallucination guard and a separate apportionment-citation validator run the same check on those two higher-stakes surfaces specifically.

Escobedo

The substantial-evidence standard AOE/COE causation is held to.

Brodie / Strait

The three-prong test the §4664 prior-award offset engine runs.

Hikida

The limit on apportioning impairment the treatment itself caused.

Almaraz / Guzman

When an alternate AMA Guides method may be used instead of DRE.

Dubon / Bodam

Which UR denials are eligible for IMR — gates IMR-eligibility classification.

Vázquez

The good-cause standard for late filings; the generator that builds the filing exhibit.

Step 04The exact part runs as code

The AI drafts the reasoning. It does not decide the numbers.

A handful of outputs in a WC claim cannot be a model’s best estimate — they have to be the same number every time, from the same inputs, and defensible line by line. For those, the platform routes to a deterministic engine instead of the reasoner. If the reasoner drafts its own arithmetic on the way to a conclusion, the deterministic engine’s result overrides it before the physician ever sees a number — pure functions, versioned, and audit-traced back to the inputs that produced them.

PDRS calculator

Final permanent-disability rating

2005 Schedule: FEC rank → age adjustment → occupational adjustment → final PD.

AMA Combined Values

Combined whole-person impairment across multiple ratings

AMA Guides to the Evaluation of Permanent Impairment, 5th Edition — the California standard.

§4664 offset engine

Prior-award offset against the current rating

The Brodie / Strait three-prong test, applied the same way on every case.

QME §4062 state machine

Panel-process step and the evaluation window it triggers

The §4062 / §4062.5 panel sequence, tracked as states, not as free text.

Deadline arithmetic

Every statutory clock in the claim

Business-day math against the California DWC holiday calendar, re-run daily at 07:00.

Every statutory clock, holiday-aware.

The same deterministic posture applies to time. Each clock below is computed against the California DWC holiday calendar, not a generic business-day count, and re-checked by a daily 07:00 cron that surfaces approaching and overdue items before they lapse.

  • DWC Form 5021 — 5 business days from first treatment.
  • PR-2 progress reports — every 45 days, or on material change.
  • §4610 utilization review — 5 business days standard, 72 hours expedited, 30 calendar days retrospective.
  • §4610(g)(2) auto-authorization — detected and applied automatically when the window is missed.
  • §4610.5 independent medical review — 30 days plus a 5-day mail allowance.
  • §4062.1 / §4062.2 QME panel windows — tracked as states, not deadlines alone.
Step 05It argues with itself first

A self-critique pass, before a physician ever sees the draft.

Every specialist in the Round Table runs Chain-of-Verification on its own output: an initial answer, then a set of adversarial verification questions — did I invent anything not in the record? What would opposing counsel argue against this? Would this survive cross-examination? — and only then a revised final answer. The self-critique happens before the draft ever reaches the physician’s screen.

What the physician sees while this runs is a live, honest reasoning trace: which specialist is working, which guideline it retrieved, which sources it found — a structured account of what happened, not raw model output and not a progress bar faked to look busy.

Defend This takes the same discipline further on request: the platform argues against its own determination first, in the voice of the defense QME, the UR reviewer, or the carrier, and assembles what it can into a submit-ready defense packet — honest about what it can’t yet answer.

Step 06The physician’s signature

Nothing is final until a licensed physician says so.

Must review before final

Decision-support output. Clinician review and attestation required before this content is signed into the chart.

The must-review-before-final gate is enforced at the data layer, server-side — not a banner a browser could skip. The physician sees the visible reasoning that produced the draft, not just the draft itself, can edit any clause, and only then attests. That review-and-attest step is what AB 3030 / SB 1120 disclosure and AB 489 require, and here it is architecture, not a policy memo: there is no path from an AI draft to the chart, a payer, or an attorney that skips the physician.

The architecture also errs toward the person the process is supposed to protect: if the IMR-eligibility classifier can’t reach a confident answer, it fails open rather than closed, so a worker’s appeal window is never lost to a classification error.

Step 07Sealed and checkable

The signature becomes a fact anyone can check.

At the moment of attestation, a SHA-256 hash binds the physician’s signature to the exact rendered document — the specific PDF, the specific content, at that specific moment. Four public verification endpoints, one each for IMR, QME, PTP-QME, and closure documents, let anyone holding a copy confirm it hasn’t been altered since it was signed. No login, no PHI in the check, and the endpoints are rate-limited against abuse.

That means a payer, an opposing attorney, a QME, or the DWC itself can verify authenticity independently of ChironAI — the proof doesn’t depend on trusting the vendor that produced the document.

Read the security posture →
Agentic, not autonomous

The reasoning is agentic. The math is exact.

Across all seven steps, Chiron takes initiative — it reads the whole record, decides which specialists a case needs, retrieves the guideline that supports each claim, and interrogates its own draft before anyone else sees it. That is the agentic part, and it runs without being asked at every step. But twice in every case, the architecture deliberately hands off: the moment a number has to be exact, it hands off to a deterministic engine that cannot drift; the moment a determination has to be made, it hands off to a licensed physician who signs. Agentic reasoning, bounded by two places where the system is built not to decide.

Read: agency, not autonomy →
A note to the reader

Want to watch the Round Table convene on a case like yours?