Cognitive Complaints Without Objective Findings: How Neuropsychologists Approach Disputed Claims

A common challenge in medicolegal practice is the presence of reported cognitive difficulties in the absence of clear objective findings.

For solicitors, understanding how a neuropsychologist approaches these cases is crucial when managing expectations and evidential risk.

Subjective Complaints vs Objective Evidence

Clients may report difficulties with:

• Memory

• Concentration

• Multitasking

• Mental fatigue

These complaints may be genuine, yet not always supported by objective test results. This does not automatically invalidate the claim, but it does require careful expert analysis.

The Neuropsychological Assessment Process

A medicolegal neuropsychological assessment examines:

• Performance across multiple cognitive domains

• Internal consistency of results

• Comparison with normative data

• Behavioural observations during testing

Importantly, conclusions are not drawn from isolated scores but from patterns of performance.

Symptom Validity and Effort Testing

In disputed cases, neuropsychologists routinely assess:

• Test-taking effort

• Response consistency

• Plausibility of symptom presentation

These findings are critical in distinguishing between:

• Neurological impairment

• Psychological factors

• Exaggeration or misattribution

Failure to consider symptom validity significantly weakens expert evidence.

Psychological and Contextual Factors

Cognitive complaints may arise from:

• Anxiety or depression

• Pain and fatigue

• Stress related to litigation

• Sleep disturbance

A robust medicolegal report will explore these factors without defaulting to simplistic explanations.

Implications for Causation and Quantum

Where objective impairment is not demonstrated, the neuropsychologist’s role is to:

• Clearly explain the findings

• Set out alternative explanations

• Avoid speculative conclusions

This clarity assists solicitors in evaluating prospects, advising clients, and responding to opposing expert evidence.

Cognitive complaints without objective findings are a frequent feature of medicolegal cases.

A skilled medicolegal neuropsychologist provides balanced, evidence-based analysis that withstands scrutiny and supports informed legal decision-making.

In regions such as Devon and Cornwall, early access to such expertise can prevent unnecessary escalation of disputed claims.