Lawyers Want Definite Answers from Medicolegal Experts
This is part of a three-part series examining how psychiatrists in medicolegal practice can effectively bridge the gap between clinical complexity and legal clarity.
One of the realities of medicolegal work is that lawyers often want definite answers — even when psychiatry deals mostly in shades of grey. It’s not because they want to pressure or corner us. It’s because their role in litigation is fundamentally different from ours.
When a lawyer refers their client to us for an independent medicolegal examination, they’re trying to establish two key things:
Whether the examinee meets the threshold for a diagnosable psychiatric condition according to recognised diagnostic criteria (DSM-5 or ICD-11).
Once that’s established, whether that condition has caused impairment significant enough to attract damages (sometimes using impairment ratings and assessments of whole person impairment, depending on the jurisdiction.
The lawyer’s job is to fit our opinions into a legal framework, not a clinical one. And that’s the difference for us to appreciate as we move away from communicating with colleagues and towards communicating with legal professionals.
This can feel more straightforward in orthopaedic or surgical cases, where there’s often an identifiable injury — a fracture, a tear, an infection — and objective imaging or pathology results to confirm it.
For psychiatrists we have a history obtained from an examinee and supporting documents to substantiate or refute what we are told. And in contrast, the examinee’s injuries are invisible, although we can present them in the form of a mental state examination.
In addition, their conditions may fluctuate over time, relapse and remit, and be influenced by concomitant life experiences, psychosocial stressors and personality structures.
The causal links between an event and a psychological condition are rarely clean or linear.
So when a lawyer asks, “Does this person have PTSD as a result of that incident of abuse ?” it’s understandable that we hesitate — because in psychiatry, cause and effect are rarely singular. Yet, that’s exactly the question the court needs us to answer.
Even if we’re uncertain, we can still express a view on balance of probabilities — the standard the court requires. This doesn’t mean overstating confidence or ignoring complexity. It means translating clinical nuance into legal clarity. Instead of “unclear whether PTSD is present,” we can say “although symptoms overlap with depression, on balance the criteria for PTSD are not fully met.”
The best medicolegal reports are not those that hedge every statement, but those that are carefully reasoned, evidence-based, and clear about where uncertainty lies — while still providing an opinion that helps the court decide.
In short: our role isn’t to be infallible—it’s to be useful.