AI tools typically rely on simplified inputs such as injury severity, treatment duration, and billed costs. Those inputs don’t always reflect what matters most in a real case—especially when the timeline is complicated.
In the San Rafael area, many claims involve situations like:
- Specialist handoffs where diagnostic reasoning is delayed or communication gets fragmented between providers.
- Follow-up gaps (missed calls, scheduling issues, or unclear discharge instructions) that allow a condition to worsen.
- Medication and monitoring problems that only become obvious after symptoms change.
- Post-procedure complications where the chart shows multiple visits, but causation is disputed.
An AI calculator may not know whether the missing link is medical causation, documentation, or a standard-of-care issue. If the inputs are incomplete—or if key facts aren’t captured—the output can swing dramatically.


