The following are Dr. Silva’s answers to questions that she is frequently asked before being retained for a case:
What can a neuropsychological evaluation offer in a medical-legal context?
A neuropsychological evaluation includes use of standardized tests that provide objective information regarding an individual’s cognitive and psychological functioning. The cognitive tests assess various domains, including: attention, processing speed, motor and sensory functioning, intellectual abilities, visuospatial and perceptual abilities, expressive and receptive language, verbal and visual memory, and higher-order executive functions. Additionally, the tests include measures of performance and symptom validity that provides information about the examinee’s response style on testing. The clinical interview and record review complete the neuropsychological assessment. The results of the neuropsychological testing are then correlated with what is scientifically known about the neuropsychological conditions in question, and opinions regarding causation and impairment can be made.
Why does board-certification in neuropsychology matter?
There is not a specific license for neuropsychologists, rather, we are licensed as psychologists in most states. However, most psychologists have not met training standards that are specific to neuropsychology, which include courses and clinical experiences related to neuroscience, not to mention completion of two-years of postdoctoral training in neuropsychology. Thus, finding a neuropsychologist who is board-certified provides assurance that the neuropsychologist has met the criteria for specialization and passed a rigorous, four-part examination procedure to obtain that certification. More information about the board-certification process can be found here.
Will you provide psychological opinions in addition to cognitive opinions?
Yes. I was primarily trained as a clinical psychologist with a specialty in behavioral medicine, prior to going on to continue my specialized training in neuropsychology. I always comprehensively evaluate psychological functioning and psychosocial factors when performing a neuropsychological evaluation.
What percentage of Defense vs. Plaintiff’s work have you done as a retained expert?
As of June 2024, about 70% for the Defense and 30% for the Plaintiff’s attorney. I will always have a conversation with an attorney prior to being retained for a case. If there does not appear to be objective factors that a Plaintiff has sustained a traumatic brain injury, I will inform the attorney upfront that my evaluation would not support their claim that any potential cognitive impairment that may be found on neuropsychological testing is due to an alleged TBI.
How many medical-legal evaluations have you done?
I typically do about 30-50 per year, which includes IMEs, workers’ compensation evaluations (QME, AME, AOE/COE), fitness-for-duty evaluations, and personal injury cases. I have been doing medical-legal evaluations since 2011.
How many times have you testified?
As of June 2024, I have been deposed 25 times and have testified in court three times.
Do you speak Spanish?
Yes, I speak Spanish and do not require an interpreter for Spanish-language evaluations. I also ensure that the neuropsychological tests I administer are culturally and linguistically appropriate for the examinee, as well as use appropriate norms for interpretation of the data.
Are you willing to travel for cases?
Yes, I am willing and able to travel for cases I am retained on.