The Neuropsych Eval Is Not the Whole Picture
In a TBI case, the neuropsychological evaluation is one of the most powerful clinical tools available to either side. It isn't a scan. It isn't a blood test. It's a carefully constructed series of standardized tests that measures how a brain is actually functioning... memory, processing speed, attention, executive function, language, visual spatial reasoning. Each test is designed to detect patterns that map to specific types of injury. And when it enters a legal case, it becomes the center of a fight most attorneys experience as a discovery dispute. What it actually is is a clinical chess match.
Linda Acker FNP-C
7/16/20263 min read
Why the Instruments Are Protected
The tests used in a neuropsychological evaluation are clinically controlled by the psychological community for one specific reason. The moment a patient has been exposed to the test content, the test isn't valid for that patient anymore. You can't administer a standardized evaluation to someone who already knows what's coming.
That protection exists to preserve the scientific integrity of the instruments. It also means that when the eval enters litigation, the clinical community stays the gatekeeper regardless of what either side wants to do with the data.
The 2025 New York Case
A woman was injured in a car accident. She claimed a concussion, post-concussion syndrome, and traumatic brain injury. The defense requested their own independent neuropsychological evaluation, which is a standard move in a TBI case.
The way that request was written, no neuropsychologist would agree to conduct it. Whether that was intentional doesn't change the clinical effect. No evaluator means no defense neuropsych expert. In a case where the entire injury is a brain injury, that's a significant gap.
The plaintiff's counsel recognized the move and countered. The client would come in for evaluation, but the testing materials and the raw data would stay with the plaintiff's clinical team. The defense pushed back. The case went back and forth. The courts kept affirming the plaintiff's position.
The language on a neuropsych eval request determines who will agree to conduct it and under what conditions. That isn't a procedural detail. The wording of the request is the first move on the board.
What the Eval Actually Produces
A neuropsychological evaluation produces two things.
The report is the clinician's written interpretation. The conclusions they reached about how the brain is functioning and why. The raw data is everything that actually happened during the testing. Every sub-test score, every response, every pattern across dozens of measures.
The report is what the evaluator decided. The raw data is what they saw when they decided it.
Two neuropsychologists can look at the exact same raw scores and reach completely different conclusions. Not because one of them is dishonest... because clinical interpretation isn't a math problem. It's a judgment call, and judgment calls are shaped by what the clinician is looking for and how they weigh what they find.
A defense neuropsychologist and a plaintiff's neuropsychologist aren't starting from the same clinical posture. That doesn't make either one wrong. It makes the raw data critical. Without it, you're arguing against a conclusion you can't examine at its foundation.
The Validity Measures
Embedded in most neuropsych evaluations are validity measures. These are tests within the test, designed to detect whether the patient is performing below their actual ability. How those measures are scored and interpreted is often where the malingering arguments get built or dismantled.
That analysis lives in the raw data.
I'm not going to walk through how validity measures work or how to challenge them. That's a clinical conversation that happens one on one. What I will tell you is that without access to the raw data, you can't engage with that argument at the level it deserves.
What the Court Got Right
The resolution in this case was clinically appropriate. The testing materials and raw data could go to the plaintiff's clinical team, but only to a licensed psychologist or neuropsychologist. The clinical community stays the gatekeeper. The instruments stay protected. But within that boundary, the plaintiff's experts get to examine the foundation... not just the conclusion.
That's the only outcome that makes clinical sense. A fair evaluation of any expert's conclusion requires access to what those conclusions are actually based on. In neuropsychology, that means the raw data. Without it, you aren't doing a clinical review. You're doing a summary review. Those aren't the same thing.
What This Means for Your Case
If you have a TBI case with a neuropsych eval in it, the report you received is the beginning of the clinical conversation. The patterns in the raw data, how the validity measures were administered and scored, whether the testing battery was appropriate for this type of injury, whether the conclusions in the report hold up against what the scores actually show... those questions require someone who understands what they're looking at.
A neuropsych report without clinical eyes on the data underneath it is an incomplete picture. And in a case where the entire injury is a question of how someone's brain is functioning, incomplete isn't good enough.
If you have a case where this work needs to happen, that's the conversation I have. Link is in the show notes. My availability is limited and not every case is the right fit.
The Lawyer's NP is for educational and informational purposes only. Content does not constitute medical or legal advice and does not establish an expert witness relationship. Science and law evolve... consult a qualified professional regarding the specific facts of your case. Reliance on any information provided by Linda Acker, FNP, or Clear Advantage LNC is solely at your own risk.