Why Retain a Forensic Neuropsychiatrist

BNNP fellowship training is distinct from both neurology residency and psychiatry residency. While neurology focuses on the diagnosis and treatment of diseases of the nervous system, and psychiatry focuses on mental health conditions, BNNP occupies the space between them, specifically training physicians to understand what happens to a person's thinking, personality, emotions, and behavior when their brain is damaged or diseased.

This is the precise question at the center of most forensic cases involving brain pathology: How did this brain injury or disease change this person's mind and behavior, and what are the consequences?

Dr. Lodhi completed his BNNP fellowship at Stanford University School of Medicine. Per the UCNS curriculum, BNNP training covers neuropsychiatric assessment (bedside cognitive examination, mental status examination, standardized neuropsychiatric rating scales), clinical interpretation of neuropsychological test results, correlation of neuroimaging findings with clinical presentation, neuropharmacology, and the diagnosis and management of neurobehavioral syndromes including personality and behavioral change due to brain injury or disease. Combined with his forensic psychiatry fellowship (also completed at Stanford), this creates the dual expertise that complex brain-behavior cases demand.

What Neurologists Bring to a Case

Neurologists are essential for diagnosing and documenting diseases of the nervous system: stroke, epilepsy, multiple sclerosis, Parkinson's disease, brain tumors. In litigation, a neurologist can identify the anatomic location and nature of brain pathology, interpret neuroimaging from a neuroradiological perspective, and opine on neurological prognosis. Their testimony is strongest when the legal questions concern the medical facts of the brain injury or disease itself. In many complex cases, a neurologist's findings provide the foundation on which neuropsychiatric opinions are built.

What a Neurologist Alone Cannot Address

Neurologists typically complete residency training without formal training in psychiatric diagnosis, behavioral assessment, or psychosocial functioning. When a TBI case turns on personality changes, emotional dysregulation, or lost executive function (as most do), a neurologist alone may struggle to connect the brain pathology to the behavioral and psychiatric outcomes that actually drive damages. According to published surveys, fewer than 15% of neurology residency programs include structured rotations in behavioral neurology or neuropsychiatry.

Forensic evaluation methodology is a separate area of specialization. Neurologists do not typically train in the legal standards for competency, capacity, causation, or malingering detection. When a neurologist is testifying about the psychiatric consequences of brain injury, attorneys should expect opposing counsel to probe the boundaries of neurological training on these questions. Pairing a neurologist with a forensic neuropsychiatrist addresses this directly.

When to Retain Both: The Neuropsychiatrist-Neurologist Team

In complex brain-behavior cases, the strongest approach is often to retain both a neurologist and a forensic neuropsychiatrist. The neurologist establishes the neurological diagnosis, documents the brain pathology on imaging, and opines on neurological treatment and prognosis. Dr. Lodhi then builds on that neurological foundation, connecting the documented brain pathology to the psychiatric, cognitive, and behavioral consequences, providing the forensic framework for causation and damages, and addressing malingering and differential diagnosis. Each expert reinforces the other from an independent discipline, and opposing counsel cannot dismiss the behavioral testimony by attacking neurological credentials or vice versa.

The Three-Expert Framework

In the most complex matters (severe TBI with disputed cognitive deficits, CTE claims, neurotoxic exposure with multi-domain impairment), attorneys should consider the three-expert team: a neurologist for brain pathology documentation, a neuropsychologist for objective cognitive testing data, and Dr. Lodhi as the integrative forensic neuropsychiatrist who synthesizes both into a unified causation-to-damages formulation. This three-expert framework covers every dimension of the case and is exceptionally difficult for opposing counsel to dismantle because each expert's findings independently corroborate the others.

When Dr. Lodhi Alone May Suffice

When budget or case complexity requires a single expert, Dr. Lodhi's BNNP fellowship training at Stanford enables him to address both the neurological and psychiatric dimensions. He can review and correlate neuroimaging findings with clinical presentation, assess psychiatric conditions, and connect the two in a forensic framework. His forensic psychiatry fellowship (also at Stanford) ensures evaluations meet legal standards and testimony is structured for courtroom impact. For cases where brain pathology is well-documented and the primary disputes concern behavioral and psychiatric consequences, Dr. Lodhi as a sole expert can address the full chain of causation: brain pathology → neuropsychiatric consequences → functional impairment → damages.

What Neuropsychologists Do Well

Forensic neuropsychologists are experts in administering standardized neurocognitive test batteries and interpreting the resulting data. They can characterize patterns of cognitive impairment, assess effort and symptom validity, and compare performance to normative data. Their testing data provides objective, quantifiable evidence of cognitive deficits, and provides powerful evidence in TBI and capacity cases. Approximately 85% of forensic TBI cases include neuropsychological testing data.

What Neuropsychologists Cannot Do

Because neuropsychologists hold doctoral degrees (PhD/PsyD) rather than medical degrees, they cannot render medical diagnoses, provide medical causation opinions, correlate neuroimaging with clinical findings, prescribe or opine on medication effects, or perform physical examinations. In cases where opposing counsel challenges the causal link between a brain injury and the claimed deficits, a neuropsychologist alone may not be able to close the gap. They can describe what the testing shows, but not why it shows it from a medical standpoint.

When to Retain Dr. Lodhi Alongside a Neuropsychologist

The strongest approach in complex brain-behavior cases is to retain both: the neuropsychologist provides the objective testing data, and Dr. Lodhi provides the medical interpretive framework, integrating test results with clinical examination, medical history, neuroimaging reports, and psychiatric assessment into a unified formulation that addresses causation, diagnosis, prognosis, and damages. This two-expert model is difficult for opposing counsel to dismantle because each expert reinforces the other's findings from an independent discipline.

A general forensic psychiatrist has completed psychiatry residency and a forensic psychiatry fellowship. This training is excellent for evaluations involving psychiatric disorders in legal contexts (competency to stand trial, criminal responsibility, risk assessment, disability evaluations). General forensic psychiatrists are the appropriate experts when cases do not involve brain pathology.

However, when the case involves traumatic brain injury, dementia, CTE, neurotoxic exposure, or any condition where brain disease or injury is causing psychiatric and behavioral symptoms, a general forensic psychiatrist lacks the specialized training to correlate neuroimaging findings with neurobehavioral presentation, diagnose neurocognitive disorders with confidence, or render causation opinions linking specific brain pathology to specific behavioral outcomes. This is precisely the territory that BNNP fellowship training covers.

Dr. Lodhi's dual training means attorneys do not have to choose between forensic rigor and neuropsychiatric depth. His forensic fellowship ensures evaluations meet legal standards and testimony is courtroom-ready. His BNNP fellowship ensures the neuropsychiatric analysis is grounded in specialized training, not extrapolation from general psychiatric knowledge.

The right expert team depends on case complexity, the questions at issue, and the strength of the evidence you need to present. Here is a practical framework for deciding whether to retain Dr. Lodhi alone, alongside a neuropsychologist or neurologist, or as part of a three-expert team.