IME staff workflow with AI: who does each step
Short version: 4 roles carry an IME file through AI. The intake coordinator logs the referral and sends the notice, the records coordinator runs the tool and checks page counts, the examining physician verifies cited pages and writes every opinion, and the office manager closes the log before the report goes out. No step is skipped because the software ran.
Limits: This site gives templates and a process, not legal advice. We read the rules it cites on 2026-11-12; your state, your requesters' contracts and your counsel decide what your practice must do.
The 4 roles
Small practices combine roles; a solo examiner holds all 4. What matters is that each step has a named owner and that the person who runs the tool is not the only person who checks it.
- Intake coordinator: opens the case, records the requester's questions and deadline, sends the examinee notice, marks "no AI" cases.
- Records coordinator: uploads records to the approved tool, checks the page count and the missing-records list, opens the log entry.
- Examining physician: verifies the cited pages behind the opinion, examines, writes and signs. Reads every sentence of any draft.
- Office manager: keeps the approved tools list, checks the log is complete, releases the report, runs the monthly log review.
Step by step, with the check at each handoff
| # | Step | Owner | Handoff check before the next person starts |
|---|---|---|---|
| 1 | Open the case; record the requester, the questions asked, the deadline and any AI terms in the requester's contract | Intake coordinator | Questions copied word for word from the referral |
| 2 | Send the appointment letter with the examinee notice | Intake coordinator | Notice date in the log; "no AI" flag set if the examinee objected |
| 3 | Remove other people's documents, then upload records to an approved tool | Records coordinator | Tool and plan match the approved tools list |
| 4 | Compare the tool's page count with the cover letter; read the duplicate and missing-records lists | Records coordinator | Any gap is written in the log and, if it matters, requested from the requester |
| 5 | Open the log entry for the run | Records coordinator | Case number, date, tool, task, inputs filled |
| 6 | Read the chronology; open the source page for every fact the opinion will rest on | Examining physician | Corrections noted in the log; handwritten dates checked by hand |
| 7 | Take the history, examine, record findings | Examining physician | Check-in script read and logged |
| 8 | Draft the report from the physician's notes and the checked chronology | Physician, or the tool under the physician's direction | Opinions written by the physician, not suggested by the tool |
| 9 | Edit every sentence; build the records-reviewed list from records actually read; add the methods sentence | Examining physician | No record on the list that was only summarized |
| 10 | Sign | Examining physician | Physician initials the log row |
| 11 | Confirm the log row is complete, then release the report | Office manager | Every field filled; no open corrections |
Who does what, at a glance
R runs the step, A answers for it, C is consulted, I is informed. Only 1 A per row.
| Task | Intake | Records | Physician | Office manager |
|---|---|---|---|---|
| Approve a new AI tool | I | C | A | R |
| Examinee notice | R | I | A | C |
| Upload and page check | I | R | I | A |
| Verify facts behind the opinion | C | R, A | ||
| Opinions and signature | R, A | |||
| Log complete before release | C | R | C | A |
| Monthly log review | C | A | R | |
| Incident report | R if seen | R if seen | A | C |
California workers' comp files
For medical-legal reports in California workers' compensation, Labor Code 4628 tightens steps 6 and 9. Subdivision (a) keeps nonclerical preparation of the report with the signing physician, (b) has the report name each person who performed services other than clerical work, and (c) says that when someone other than the physician excerpts prior records, the physician reviews the excerpts and the entire outline. Treat a software chronology like any other excerpt: the physician reads it in full. QME practices should take the specifics to counsel.
Addenda: when the file comes back
- The intake coordinator opens a new log entry under the same case number, marked "addendum".
- The records coordinator uploads only the new records, or the full file if the tool needs it, and notes which.
- The tool lists what is new. The physician reads every new record the addendum relies on, not only the list.
- The physician states whether the opinion changes and why. The tool does not suggest that answer.
- The office manager closes the addendum row before release, the same as for the first report.
The 3 failure points to watch
- The upload that skips the list. A coordinator under deadline uses a tool or plan that is not approved. The fix is technical as well as written: block personal chatbot sites on office machines.
- The physician who reads only the summary. Step 6 gets compressed when the chronology looks clean. The log's verification field, initialed by the physician, makes the skip visible.
- The report released with an open row. Step 11 exists to stop it. Make "log closed" a field the case system checks before release, if your system allows it.
The fields each step writes are on the audit trail page.