Forensic SLP vs. LNC vs. Physician Record Reviewers

Why “Invisible” Communication Injuries Get Missed — and How to Fix It

TL;DR for attorneys

If your case involves communication, cognition, executive function, swallowing, voice, or real-world functioning, a Forensic Speech-Language Pathologist fills a critical evidentiary gap that Legal Nurse Consultants and physician record reviewers cannot.

The Problem: Records Describe Diagnoses — Not Function

Most litigation relies on:

• physician chart reviews

• nurse summaries

• diagnostic labels

But diagnosis ≠ daily functioning.

Clients don’t live in ICD codes. They live in:

• missed conversations

• unsafe swallowing

• inability to organize tasks

• communication breakdowns at work

• loss of independence in ADLs

These functional losses are rarely documented clearly in medical records — especially in “mild” TBI, post-concussive syndrome, stroke recovery, anoxic injury, or complex neurological cases.

That’s where cases quietly lose value.

What a Legal Nurse Consultant (LNC) Does Well

LNCs are invaluable for:

• organizing medical timelines

• summarizing care sequences

• identifying deviations from standard nursing care

• flagging chart inconsistencies

What they do not do:

• assess communication or cognition

• evaluate executive functioning

• translate functional communication loss into courtroom-ready language

• test how impairments show up in real life

LNCs interpret records.They do not measure functional communication performance.

What Physician Record Reviewers Do Well

Physicians are essential for:

• diagnosis confirmation

• medical causation opinions

• imaging interpretation

• disease progression

Limitations:

• Appointments are brief

• Functional communication is often under-tested

• Notes prioritize medical stability, not quality of life

• Subtle deficits are frequently documented as “WNL”

A clean MRI does not mean a client is functional.Courts increasingly understand this — but only if it’s explained properly.

What a Forensic SLP Does Differently

A Forensic Speech-Language Pathologist specializes in:

• cognitive-communication functioning

• language, memory, attention, executive skills

• voice, swallowing, and speech reliability

• real-world communication demands

more here...

But more importantly:

We translate impairment into impact.

Not just:

“The client has aphasia.”

But:

“This impairment prevents the client from following multi-step instructions, participating in workplace meetings, managing medical care independently, and maintaining prior employment.”

That difference matters in valuation.

Why Clinical Experience Matters in Forensics

I’ve spent years treating patients, not just reviewing records.

That means I know:

• how diagnoses actually present day-to-day

• how “mild” deficits compound into major disability

• how clients mask impairment during brief medical visits

• how communication breakdowns erode independence, employment, and relationships

This perspective is missing when analysis stays purely on paper.

Records tell you what was written.Clinical experience tells you what was lived.

Where Forensic SLPs Add the Most Value

A Forensic SLP is most impactful when:

• MRI/CT is “normal” but function is not

• damages feel real but hard to articulate

• communication issues affect credibility, employability, or independence

• attorneys need objective language for demand packages

• expert testimony must explain the “software,” not just the “hardware”

We do not replace physicians or LNCs.We complete the evidentiary picture.

Bottom Line for Litigation Teams

Role	Strength	Limitation
LNC	Medical organization	No functional testing
Physician reviewer	Diagnosis & causation	Limited real-world analysis
Forensic SLP	Functional communication & QOL	Often underutilized

If communication, cognition, or swallowing affects ADLs, employability, safety, or credibility, omitting a Forensic SLP leaves money on the table.

If you want clean records summarized, hire an LNC.If you want diagnoses confirmed, hire a physician.If you want invisible functional loss translated into damages, hire a Forensic SLP.