Artificial intelligence tools are increasingly being used to research information, summarize documents, and assist with written communications.
However, disability claims involve sensitive medical information, legal documents, attorney communications, and claim strategy. When case-specific information is entered into public AI platforms, it may create confidentiality concerns and introduce risks that are not immediately apparent.
For individuals involved with Social Security Disability (SSD) or disability cases with insurance carriers (Long Term Disability, Short Term Disability, or individual disability claims), understanding how AI tools intersect with the legal process process is becoming increasingly important.
How are AI tools being used in disability claims?
AI tools may be used by different participants in the disability claims process, including claimants, claimant representatives, insurers, and administrative agencies, primarily to support general informational or administrative tasks. However, disability determinations still require analysis of specific facts, medical evidence, policy language, and applicable legal standards.
Common uses include:
- Summarizing medical records
- Reviewing claim documents
- Drafting communications
- Asking general questions about benefits, procedures, or claim status
The limitation is that disability determinations are not made from generalized summaries. Whether a claim is supported depends on the specific evidentiary record, including documented functional limitations, the progression of the medical condition, and the governing disability standard under the applicable program or policy (such as SSD, STD, LTD, or IDI).
Generalized AI outputs may not account for how medical evidence is evaluated in context, how policy definitions are applied, or how procedural requirements affect claim development and adjudication.
What confidentiality issues can arise when AI tools are used?
Disability claims often involve sensitive information, including medical records, claim documents, and communications with counsel.
Information that generally should not be entered into public AI platforms includes:
- Medical records and treatment information
- Diagnoses and functional limitations
- LTD policies or claim correspondence
- Denial letters and appeal documents
- Communications between attorney and client
- Questions involving claim strategy or potential outcomes
The concern is not the use of AI itself. The concern is whether confidential claim information is being shared in a setting that may not provide the same protections and confidentiality as communications with legal counsel.
Disability claims often require review of information that is both personal and legally significant. Sharing that information outside the attorney-client relationship may raise questions about how it is stored, used, or protected.
Do AI platforms provide the same protections as attorney-client communications?
No. Communications between attorneys and clients are protected by attorney-client privilege and confidentiality obligations, but public AI are not afforded the same privacy safeguards.
When claim-related information is entered into a third-party AI system, attorneys and clients should consider that the information is not protected as a direct communication with counsel.
This distinction is particularly important in disability matters, where the claim record may contain personal and highly sensitive information, including medical history, personal identifiers (address, phone number, identification numbers), functional limitations, employment information, and legal strategy considerations.
Can AI accurately evaluate an LTD or SSD claim?
AI tools can provide general information, but disability claims require review of the specific facts and evidence involved.
For example, an LTD claim may depend on:
- The language of the disability policy
- The applicable definition of disability
- Medical evidence supporting functional limitations
- The insurer’s interpretation of the claim record
An SSD claim may depend on:
- Medical evidence and limitations
- Nuances regarding a person’s past work experience
- Specific limitations proposed by medical professionals
A response generated from general information may not identify evidentiary gaps, procedural issues, or inconsistencies that affect the claim.
Disability determinations are also based on more than a diagnosis. The record must often demonstrate how a condition affects a person’s ability to perform specific work-related activities over time. Specific and sometimes small functional limitations may be outcome-determinative, facts that AI may not understand.
An AI-generated summary may identify diagnoses or treatment history while missing important details such as:
- Restrictions and limitations documented by providers
- Changes in functional ability
- Inconsistencies within the medical record
- Evidence needed to support a disability standard
What risks can arise when AI is used to review claim documents?
One issue is that AI tools may summarize information without identifying its legal significance.
A denial letter, medical record, or appeal document may involve:
- Policy interpretation
- Administrative deadlines
- Documentation gaps
- Inconsistencies within the claim record
A summary may capture the basic information while missing issues that require legal analysis.
For example, a denial may appear straightforward when summarized, but the underlying issue may involve how the insurer interpreted policy language, evaluated specific pieces of medical evidence, or applied the applicable disability standard.
Protecting Privilege: Guidance on Client Use of AI Platforms
Given these risks, OBD advises against claimants and claimant representatives entering case details or confidential information into public AI platforms. Purpose-built platforms with appropriate safeguards do exist for legal work, but general-use AI tools are not a substitute for attorney guidance. Entering case-specific information into these platforms can expose it to discovery outside the protection of attorney-client privilege, and the accuracy of any resulting output cannot be guaranteed. Clients with questions about their case should raise them directly with counsel rather than relying on AI to research or interpret their situation.