Messaging for Clients During Medical-Legal Assessments

After many years conducting medical-legal assessments, a constant theme that I encounter is how stressful these assessments can be for clients. Whether it’s part of a catastrophic (CAT) determination, situational assessment, or future cost of care (FCC) evaluation, clients often express uncertainty about what to expect and worry about how their performance might affect their case.

 As an occupational therapy assessor or Life Care Planner, it’s important to conduct thorough and objective evaluations, while appropriately supporting clients through the process so they can participate to the best of their ability. I’ve outlined some key steps for addressing this important practice issue.

1. Explain the Purpose

It’s important to go beyond the basics of what you need to do to obtain informed consent. More than explaining who initiated the referral and what it will involve, explaining the why of the assessment is key. By clarifying that the goal is to understand their functional abilities and limitations in the context of their environment, we can ease worries and set realistic expectations. Clear messaging about purpose can help clients to feel less like they’re being “judged”.

 A clear explanation can sound like:

“Today’s assessment is about understanding what tasks you can do comfortably, which ones are difficult, and what supports might make things easier — it’s not about passing or failing.”

2. Be Transparent

Many people experience increased stress when they’re uncertain about what’s to come. The more information we provide, the more likely we are to see full engagement from our clients. I explain what each activity involves, approximately how long it will take, and why specific observations are being made. Transparency fosters trust and helps clients feel more at ease when challenges arise during testing. I find that when clients understand what I’m observing, they often participate more openly, offering richer insights into their functional experiences.

For instance:

“I have a short list of common housekeeping activities that I’d like you to try. For this part of the assessment, I’ve put aside one hour and during that time I’ll be taking notes based on what I observe about your physical, cognitive and emotional functioning.”

3. Monitor Comfort and Safety

Concerns about pain, fatigue, and emotional distress commonly arise during med-legal assessments. It’s important to observe subtle signs of discomfort, regularly check in with the client, and offer rest breaks as needed. Supporting a client through these moments doesn’t mean altering the assessment’s integrity — it means ensuring the process remains safe, ethical, and trauma-informed.

I try not to make assumptions about their symptoms, but rather ask open-ended questions to elicit information from them if I notice behaviour changes.

 Some ways to respectfully inquire about their symptoms and needs:

“You’ve been working on this task for some time now. How are you feeling?”

“Can you tell about your pain as you complete this activity?”

“I want to remind you that you can take a break at any time if you feel the need.”

4. End with Clarity

At the end of the assessment, I take a moment to summarize what was completed and what happens next. This helps to close the loop and ensures clients leave with a sense of closure rather than uncertainty.

 For example:

“The assessment has come to an end. I’ll be preparing a report that summarizes your performance, and it will be sent to the referral source. You won’t receive results directly from me, but you can follow up through your legal representative.”

Providing this clarity reinforces professionalism and helps manage expectations about follow-up.

Final Thoughts

Med-legal assessments can be intimidating, but with clear communication and a transparent approach, we can support the client’s safe participation throughout the assessment process. Ultimately, supporting clients through the process isn’t just good practice — it’s an integral part of conducting effective, client-centered evaluations.

 As always, I welcome opportunities to discuss topics like this with other professionals in the medical-legal space. Feel free to email me anytime at: rosa@newtonOT.com