AI agents for workers' comp claims operations.
Workers' comp files develop over days and weeks. Layerup agents continuously ingest documents, monitor work status, support compensability review, surface return-to-work signals, prepare examiner handoff packages, and route exceptions.
A long-horizon workflow, continuously executed.
Layerup agents do not handle a single moment in the file. They run alongside the examiner across the life of the claim — ingesting, summarizing, surfacing, and preparing.
FROI intake
Agents intake First Reports of Injury from any channel — portal, email, employer integration — and stage them for examiner review.
- Multi-channel FROI intake
- Required field validation
- Employer and policy match
- Initial routing
Employer / employee / injury data capture
Agents extract employer, employee, employment, and injury data points across forms, statements, and incident reports.
- Employer profile match
- Employee identification
- Injury type and body part capture
- Mechanism of injury extraction
Policy verification
Agents verify policy effective dates, classifications, endorsements, and coverage applicability against the policy admin system.
- Effective date and term verification
- Class code applicability
- Endorsement review
- Coverage determination support
Jurisdiction & statutory deadline support
Agents track jurisdiction-specific statutory deadlines and surface upcoming actions before they slip.
- Jurisdiction identification
- Statutory deadline calculation
- Action calendar preparation
- Examiner reminders
Compensability review support
Agents assemble the evidence and timeline needed for compensability decisions and prepare a recommendation packet.
- Statement and document review
- Witness and incident evidence
- Prior history reconciliation
- Compensability packet preparation
Medical record ingestion & summarization
Agents ingest medical records continuously, summarize new findings, and surface clinical changes that affect claim direction.
- Provider record ingestion
- Clinical timeline construction
- Diagnosis and treatment summarization
- Causal relationship support
Work status extraction
Agents extract work status from medical documentation — full-duty, modified-duty, off-work — and update the file in real time.
- Work status detection
- Restriction extraction
- Status change alerts
- RTW timeline projection
Provider & bill intake
Agents intake provider documentation and medical bills, classify them, and stage them for adjudication.
- Provider classification
- Bill ingestion
- Service code extraction
- Adjudication preparation
Nurse case management support
Agents synthesize file activity for nurse case managers — clinical course, RTW barriers, provider concerns, and next-step recommendations.
- Clinical course summarization
- Barrier identification
- Coordination prompts
- Care plan documentation support
Return-to-work signal detection
Agents continuously scan medical, provider, and employer documentation for early RTW indicators and route them to the right examiner.
- RTW signal detection
- Modified-duty opportunity flags
- Employer coordination prompts
- RTW packet preparation
Indemnity workflow support
Agents prepare indemnity workflow inputs — wage data, benefit calculations, and statutory references — and stage them for review.
- Wage statement ingestion
- Benefit calculation support
- Statutory rate references
- Indemnity packet staging
Litigation / denial package support
Agents assemble litigation and denial packages — evidence, timeline, statements, and rationale — for legal and senior examiner review.
- Litigation evidence assembly
- Denial rationale documentation
- Timeline construction
- Counsel-ready packet preparation
Fraud flagging
Agents flag fraud signals across statements, providers, prior history, and documentation patterns and prepare an SIU referral packet.
- Statement consistency review
- Provider pattern detection
- History reconciliation
- SIU referral packet
Subrogation flagging
Agents identify recoverable exposure — third-party liability, premises, products — and stage the recovery workflow.
- Third-party liability detection
- Premises and products signals
- Evidence assembly
- Recovery workflow trigger
Reserve support
Agents synthesize file activity to support timely, evidence-based reserve adjustments and surface drift before it becomes a problem.
- Exposure synthesis
- Reserve recommendation support
- Change driver identification
- Drift alerts
Examiner handoff package & ongoing file development
Agents continuously maintain an examiner-ready package as the file develops over days and weeks, so every interaction starts ready.
- Always-current file summary
- Open-action checklist
- Pending document tracker
- Decision-ready packet at every touch
Bring AI agents to your workers' comp operation.
Start with FROI intake, medical record summarization, or examiner handoff. Prove cycle time, file readiness, and reserve accuracy improvements — then expand.