Fitness for Duty Evaluations: What Employers Can Expect From the Process

Key Takeaways

Fitness for Duty Evaluations (FFDEs) help employers assess whether an employee can safely perform their job due to concerns about their psychological or cognitive health. Employers consider FFDEs when there are signs of behavioral changes, emotional instability, or declining performance that may affect safety or job duties.

The FFDE process includes several steps:

Referral & Clarification: Discuss concerns and evaluation scope.

Document Review: Examine relevant records.

Clinical Interview: Conduct a structured interview with the employee.

Testing: Administer standardized psychological or neuropsychological tests.

Collateral Information: Gather insights from others, if authorized.

Analysis: Combine all findings to assess the employee's fitness for duty.

Written Report: Provide a report detailing fitness, safety concerns, and recommendations without disclosing unrelated medical information.

FFDEs are not disciplinary actions; they focus on job-related functioning and help employers make informed decisions while ensuring compliance with legal standards like the ADA and FEHA. Properly conducted FFDEs protect both employees and employers by clarifying concerns and recommendations.

When is a Fitness for Duty Evaluation (FFDE) Appropriate?

Employers and attorneys often reach out to me when they’re facing one of the most challenging situations in workforce management: an employee whose behavior, emotional functioning, or cognitive abilities have raised legitimate concerns about safety, performance, or judgment. These moments are stressful for everyone involved. Leaders want to do the right thing; protect the organization, support the employee, and comply with legal requirements, but they often don’t know where to start.

A Fitness for Duty Evaluation is designed to answer one essential question:

Is the employee psychologically and/or cognitively capable of performing their job safely and effectively?

This blog will walk you through what employers can expect from the FFDE process, what I am evaluating in a psychological or neuropsychological FFDE, how decisions are made, and how the results can support defensible, ethical workforce management.

Before we begin, one important clarification: I do not conduct Fitness for Duty Evaluations for FAA-regulated pilots or aircrew. These evaluations require FAA-designated examiners and specialized aviation protocols and are outside my scope.

Let’s explore what the FFDE process looks like for the many other safety-sensitive and high-responsibility roles employers manage every day.

Why Do Employers Request Fitness for Duty Evaluations?

Employers typically consider an FFDE when there is objective evidence that an employee may be struggling with psychological, emotional, or cognitive functioning in a way that affects their work. Common triggers include:

• Behavioral changes or erratic conduct

• Emotional instability or difficulty regulating mood

• Cognitive concerns following medical or neurological events, or as a result of noticeable cognitive decline over time

• Safety incidents or near-misses

• Declining performance that appears health-related

• Concerning interactions with coworkers, patients, students, or the public

• Return to work after psychiatric hospitalization or extended leave

• Reports of impaired judgment, confusion, or disorientation

In these situations, employers are often balancing multiple priorities: safety, legal compliance, employee rights, and organizational risk. An FFDE provides the clarity needed to move forward responsibly.

What an FFDE Is—and What It Is Not

A Fitness for Duty Evaluation is a clinical and occupational assessment, not a disciplinary action. It is not designed to punish or “catch” an employee doing something wrong. Instead, it is a structured, evidence-based process that evaluates:

• Psychological functioning

• Cognitive abilities

• Behavioral patterns

• Risk factors

• Job-specific demands

The exact type of testing (psychiatric/emotional vs. cognitive/neuropsych) will depend on the referral question, the nature of the problem, and the nature of the job. The goal of testing is to determine whether the employee can safely perform essential job duties with or without accommodations.

An FFDE is not:

• A general medical exam

• A routine wellness check

• A performance evaluation

• A substitute for supervision or HR processes

• A tool for diagnosing unrelated medical conditions

It is a targeted assessment focused solely on job-related functioning, performed to answer a specific question.

The Legal Framework: ADA, FEHA, and Business Necessity

Employers often worry about whether they are “allowed” to request an FFDE. The answer is yes, when it is job-related and consistent with business necessity.

Under the Americans with Disabilities Act (ADA) and California’s FEHA, employers may request an FFDE when:

• There is objective evidence that an employee may be unable to perform essential job functions safely

• The employee’s behavior raises legitimate concerns about safety or impairment

• The evaluation is necessary to determine fitness, accommodations, or risk

The key is documentation. Employers should be able to articulate the specific behaviors or incidents that prompted concern. This is where legal counsel can be invaluable in FFDE cases. An attorney can help ensure the referral question is clear, appropriate, and defensible. This protects everyone involved, including the employee.

What Can Employers Expect From the FFDE Process?

Although each case is unique, the FFDE process generally includes the following steps.

1. Referral and Clarification of the Evaluation Question

The process begins with a consultation between the employer (or attorney) and the evaluating psychologist. During this conversation, we clarify:

• The specific concerns prompting the referral

• The employee’s essential job functions

• Relevant policies, safety standards, or regulatory requirements

• The scope of the evaluation

• What the employer needs to know to make a decision

• If there are any company-specific forms required from the evaluation

A well-defined referral question is the foundation of a defensible FFDE.

2. Document Review

Before meeting the employee, I review all relevant materials, which may include:

• Incident reports

• Supervisor statements

• HR documentation

• Medical notes (if provided by the employee)

• Job descriptions

• Performance records

• Prior evaluations or accommodations

This information helps contextualize the concerns and ensures the evaluation is tailored to the job.

3. Clinical Interview

The employee participates in a structured clinical interview covering:

• Psychological history

• Current symptoms or concerns

• Work history and job demands

• Stressors, coping strategies, and functioning

• Medical or neurological conditions

• Substance use (if relevant)

The interview is conducted respectfully and professionally. Employees often arrive anxious, which is understandable; part of my role is to create a calm, neutral environment where they can provide accurate information.

4. Standardized Psychological and/or Neuropsychological Testing

Testing is a core component of working with an FFDE psychologist in Los Angeles because it provides objective data. Depending on the referral question, testing may include:

Psychological Testing

• Mood and anxiety measures

• Personality assessments

• Trauma-related symptom inventories

• Behavioral and impulse-control measures

Neuropsychological Testing

• Memory

• Attention and concentration

• Processing speed

• Executive functioning

• Problem-solving and reasoning

• Cognitive flexibility

These tests help identify whether cognitive or emotional factors are impairing job performance. A test battery will be tailored to meet the needs of the individual evaluation, and only standardized, validated scientific measures are used.

5. Collateral Information (When Appropriate)

With proper authorization, I may gather collateral information from:

• Treating providers

• Supervisors

• HR representatives

• Occupational health

• Attorneys involved in the case

This step is especially important when there are discrepancies between reported symptoms and observed behavior, or when an employee has limited insight into their behavior or cognitive changes.

6. Integration and Analysis

Once all data is collected, I integrate:

• Interview findings

• Test results

• Behavioral observations

• Collateral information

• Job-specific requirements

This comprehensive analysis allows me to determine whether the employee is:

• Fit for duty

• Fit with accommodations

• Temporarily unfit

• Unfit for duty

The goal is clarity that allows employers and employees to move forward with a plan, with a rationale based on substantial evidence.

7. The Written Report

Employers receive a functional, job-focused report that addresses:

• Whether the employee is fit for duty

• Any safety or risk concerns

• Recommended accommodations (if applicable)

• Return-to-work guidance (if applicable)

• Suggested monitoring, treatment, or follow-up

Importantly, the report does not include private medical details or diagnostic information unrelated to job functioning. This protects employee privacy and ensures compliance with ADA and FEHA.

Profession-Specific Considerations

Different industries have different expectations, risks, and regulatory frameworks. Here’s what employers in key sectors can expect.

Law Enforcement and Public Safety

Law enforcement FFDEs require specialized expertise. Evaluations may include:

• Use-of-force decision-making

• Impulse control and emotional regulation

• Trauma-related symptoms

• Judgment and reliability

• Cognitive functioning relevant to situational awareness

Reports are written with awareness of POST-related expectations, union considerations, and administrative review processes.

Healthcare Professionals

Healthcare FFDEs often involve concerns about:

• Impairment affecting patient care

• Boundary issues or professionalism

• Stress, burnout, or emotional exhaustion

• Cognitive functioning relevant to clinical decision-making

These evaluations are conducted with sensitivity to licensing implications and hospital system requirements.

First Responders

Firefighters, EMTs, and dispatchers face unique stressors. Evaluations may assess:

• Trauma exposure

• Stress tolerance

• Emotional resilience

• Cognitive functioning under pressure

Corporate, Industrial, and High-Risk Roles

For employees in high-liability roles such as heavy equipment operators, security personnel, or laboratory workers, evaluations may focus on:

• Attention and concentration

• Reliability and judgment

• Behavioral concerns

• Psychological stability

• Safety-critical cognitive skills

How Do FFDEs Protect Employers and Support Employees?

A well-conducted FFDE benefits everyone involved.

For Employers

• Reduces liability

• Supports defensible decision-making

• Ensures compliance with ADA, FEHA, and EEOC

• Protects workplace safety

• Provides clear, actionable recommendations

For Employees

• Ensures concerns are evaluated fairly

• Identifies needed accommodations

• Supports safe return-to-work planning

• Helps connect employees with appropriate care when needed

An FFDE is not about “siding” with the employer or the employee—it is about providing objective, evidence-based information that gives everyone involved a clear path forward.

Confidentiality and Information Sharing

Employers often worry about what they can legally receive. The answer is simple:

You receive a functional, targeted report, not private medical details.

This includes:

• Fitness determination

• Safety considerations

• Job-related recommendations

The employee’s personal health information that is unrelated to the fitness for duty evaluation remains confidential.

Clarity, Safety, and Fairness: Final Thoughts From an FFDE Psychologist in Los Angeles, CA

Fitness for Duty Evaluations are one of the most powerful tools employers have for navigating complex situations involving employee behavior, emotional functioning, or cognitive concerns. When conducted properly, they provide clarity, protect safety, reduce liability, and support ethical decision-making.

If you are an employer, HR manager, attorney, or risk manager facing a challenging situation, you don’t have to navigate it alone. A well-structured FFDE through my California practice can give you the information you need to move forward with confidence.

Get the Expert Evaluation Your Organization Needs With Fit for Duty Testing in Los Angeles

Making sound, legally defensible decisions about employee fitness doesn't have to feel overwhelming. The right process makes all the difference. A Fitness for Duty Evaluation (FFDE) gives employers the clarity and confidence needed to protect both their workforce and their organization's integrity.

Dr. Stacy Reger is a licensed psychologist specializing in psychological and neuropsychological FFDEs for employers, attorneys, and safety-sensitive industries across California. Based in Los Angeles, Dr. Reger conducts evaluations statewide, and in qualifying circumstances, telehealth options may be available. Getting started is straightforward:

1. Request a consultation: Contact us to discuss your referral question and determine the right evaluation approach

2. Submit relevant documentation: Incident reports, job descriptions, medical records, and related materials help shape a thorough evaluation

3. Schedule with a qualified FFDE psychologist in Los Angeles: Dr. Reger will coordinate a time and location that works for your organization

4. Receive your report: Expect a clear, well-supported report with findings and actionable recommendations

Additional Services Dr. Stacy Reger Provides in Los Angeles and Throughout California

When you partner with Dr. Stacy Reger for a Fitness for Duty Evaluation, you're working with a psychologist whose depth of experience extends well beyond the workplace. From the initial evaluation through a comprehensive, defensible report, Dr. Reger is committed to providing clarity and actionable insight at every step of the process.

Fitness for Duty Evaluations are just one component of Dr. Reger's broad range of psychological and neuropsychological assessment services. She also conducts neuropsychological testing and psychological assessments addressing cognitive decline and learning difficulties, as well as capacity assessments for financial and testamentary matters. Her med-legal assessment services include Independent Medical Evaluations, workers' compensation psychological and neuropsychological evaluations as both a Qualified Medical Evaluator and Agreed Medical Evaluator, and adult neuropsychological evaluations for conditions such as TBI, stroke, ADHD, and dementia.

Dr. Reger also performs pre-surgical psychological evaluations for procedures including spinal cord stimulator implantation, bariatric surgery, and organ transplants. Beyond assessments, she is available as an expert witness, public speaker, and consultant, and provides individual psychotherapy and specialized therapy for older adults. To learn more about the full scope of Dr. Reger's services, explore her blog. And when you're ready to take the next step, she welcomes you to reach out directly.

About the Author

Dr. Stacy Reger is a licensed clinical psychologist (PSY #27639) with nearly two decades of experience in psychological and neuropsychological assessment. She earned her Ph.D. in Clinical Psychology from an APA-accredited program at the University of Nevada Las Vegas, and completed advanced training in clinical geropsychology at the San Francisco VA Medical Center. Her extensive background in neuropsychological testing, including building and directing a neuropsychological testing clinic at the Long Beach VA Healthcare System, gives her a uniquely rigorous foundation for conducting Fitness for Duty Evaluations. Having worked across interdisciplinary teams in complex medical, cognitive, and behavioral settings, Dr. Reger brings both clinical precision and real-world insight to every FFDE, helping employers and organizations make informed, defensible decisions about workforce safety and employee wellbeing.

What Happens if a Will Is Contested? How Testamentary Capacity, Medical History & Neuropsychology Affect Legal Outcomes

Most people assume that once a will is signed, their wishes are set in stone. In reality, wills are challenged more often than many families expect. Disputes typically arise during periods of grief, stress, or family conflict, when emotions run high. As a geropsychologist, I’m often asked to explain how mental health, cognitive functioning, and medical history influence these legal battles. Understanding the basics can help families navigate the process with more confidence and less fear.

Why Wills Get Contested

A will can be challenged for several reasons, but the most common involve questions about the person’s mental state at the time the document was created. Families may worry that their loved one was confused, pressured, or impaired. Courts take these concerns seriously, especially when the individual was older, medically fragile, or experiencing cognitive decline.

What “Testamentary Capacity” Really Means

Testamentary capacity is the legal standard used to determine whether someone had the mental ability to create a valid will. It’s a surprisingly modest threshold. At the moment the will was signed, the person must have been able to:

• Understand that they were making a will

• Know the general nature and extent of their property

• Recognize the “natural objects of their bounty” (typically family or close others)

• Form a coherent plan for how they want their assets distributed

This doesn’t require perfect memory, flawless reasoning, or even consistent clarity. Many older adults with mild cognitive impairment, early dementia, or psychiatric conditions still meet the legal standard. What matters is their mental state at the time of signing, not before or after.

How Medical and Psychiatric History Come Into Play

When a will is contested, attorneys often gather medical records, medication lists, and hospital summaries to reconstruct the person’s cognitive and emotional functioning. These records help answer key questions:

• Was the individual experiencing confusion, delusions, or memory loss?

• Were they taking medications that could impair judgment?

• Did they have a neurological condition such as dementia, stroke, or Parkinson’s disease?

• Were there psychiatric symptoms like depression, anxiety, psychosis, or delirium that might have affected decision-making?

Medical history doesn’t automatically invalidate a will. Instead, it provides context that helps the court understand whether the person’s thinking was sound when the document was executed.

The Role of Neuropsychology

Neuropsychologists are often called upon to evaluate cognitive functioning when capacity is in question. These assessments can include:

• Memory testing

• Executive-function tasks (planning, reasoning, problem-solving)

• Attention and processing-speed measures

• Language and comprehension evaluations

• Measures of judgment 

These evaluations can be done before a will is created (proactively, to reduce future disputes) or after, when the court needs expert insight. Neuropsychological findings carry significant weight because they offer objective data rather than opinion or speculation. When I am asked to do neuropsychological testing in a capacity case, I gather as much data as possible, because the stakes are high in these cases, and my opinion must be objective. It’s very important not to assume that someone has or lacks capacity before gathering all of the data.

Undue Influence: When Pressure Becomes a Legal Issue

Another common reason wills are contested is the suspicion that someone manipulated or pressured the individual. Courts look for red flags such as:

• Isolation from family

• Sudden changes in beneficiaries

• A caregiver or relative controlling access to information

• A vulnerable adult dependent on someone who benefits from the will

Psychological vulnerability due to grief, cognitive decline, or mental illness can increase the likelihood that undue influence occurred.

How Families Can Protect Against Future Disputes

A few proactive steps can dramatically reduce the risk of a contested will:

• Encourage loved ones to update estate documents while they are clearly capable

• Document cognitive evaluations when appropriate

• Ensure the drafting attorney spends time alone with the individual

• Avoid last-minute changes during medical crises

• Keep communication open among family members

These measures help preserve both the person’s wishes and family relationships.

Contesting a will is emotionally and legally complex, but understanding the role of testamentary capacity, medical history, and neuropsychology can make the process less intimidating. At its core, the legal system aims to honor the individual’s authentic intentions, and a geropsychologist is often part of the process to offer a medical opinion based on neuropsych testing, record review, and interviews with the patient and others. 

PROTECT YOUR LOVED ONE'S WISHES WITH A TESTAMENTARY CAPACITY EVALUATION IN LOS ANGELES, CA

When family members question whether a will reflects someone's true intentions, or when concerns arise about cognitive functioning at the time of signing, testamentary capacity in Los Angeles, CA evaluations provide the clarity and legal protection everyone needs. Estate disputes often emerge during periods of grief and stress, when emotions cloud judgment and documentation feels incomplete. A proactive capacity assessment can prevent costly litigation, preserve family relationships, and ensure that your loved one's authentic wishes are honored rather than contested in court.

As a trusted geropsychologist providing testamentary capacity in Los Angeles, CA evaluations, Dr. Stacy Reger understands that capacity assessments are about more than checking boxes—they're about documenting cognitive functioning with scientific rigor while honoring the person's dignity and intentions. Her approach combines comprehensive neuropsychological testing, thorough medical record review, and interviews with the individual and relevant parties to provide courts, attorneys, and families with clear, objective evidence. Dr. Reger's work ensures that decisions made today are grounded in accurate assessment—not assumption, speculation, or family conflict.

Take the next step toward legal clarity and family protection:

1. Call (424) 262-1925 to discuss whether a testamentary capacity evaluation is appropriate for your situation

2. Schedule a with a geropsychologist who specializes in estate planning cases

3. Receive a comprehensive evaluation that meets legal standards and protects your loved one's true intentions

OTHER SERVICES DR. REGER PROVIDES IN CALIFORNIA

Beyond testamentary capacity evaluations, Dr. Stacy Reger offers a full range of neuropsychological assessments and geriatric mental health services designed to support families, legal professionals, and healthcare teams through every stage of aging and cognitive change. Her practice includes comprehensive dementia evaluations, baseline cognitive assessments for proactive estate planning, pre-surgical psychological screenings, and consultations that help families understand capacity concerns before crises arise.

Dr. Reger also provides therapy for older adults and their caregivers who are managing the emotional weight of cognitive decline, family conflict around estate decisions, grief, and the difficult transitions that come with aging and loss of independence. She works closely with attorneys, financial advisors, fiduciaries, and healthcare providers to ensure coordinated care that respects both personal autonomy and legal standards. Through expert testimony, education, training, and compassionate consultation, she helps families communicate more effectively about sensitive topics and navigate uncertainty with greater confidence and less fear. For more guidance on understanding testamentary capacity, recognizing cognitive changes, and protecting estate wishes, explore Dr. Reger's blog for additional insights and resources.

How to Reduce Stigma in the Workplace Using Keynote Presentations: What Actually Works

Workplace conversations about mental health have come a long way, but stigma still shows up in subtle—and sometimes not-so-subtle—ways. In tough industries like law, healthcare, first response, construction, transportation, and death-care services, employees often feel pressure to “push through,” stay silent, or treat stress as a personal failing rather than an occupational reality.

One of the most effective tools organizations use to shift culture is the mental health keynote presentation. But not all mental health keynotes are created equal. When done well, a mental health keynote can open doors, change attitudes, and spark meaningful conversations. When done poorly, it becomes just another mandatory meeting that people forget by the next day.

So what actually works? Here are some thoughts based on my experience as a mental health consultant and speaker. I worked at the VA for a decade before going into private practice, and I have experience in aging, disability, trauma, and assessment, including neuropsychological and capacity assessment. I have presented at many organizations and companies on topics ranging from menopause to self-care and wellness for attorneys, to grief for medical and mental health professionals. I’ve picked up a few tips along the way.

1. Normalize the Conversation Out Loud and On Purpose

Mental health stigma thrives in silence. A strong mental health keynote speaker names the elephant in the room: that many employees struggle, that stress is normal, and that mental health challenges are not signs of weakness. Asking for help and support are positives, not negatives.

When leaders bring in a psychologist or mental health expert, they send a powerful message:
“We expect you to be human here.”

This alone reduces stigma. Employees feel permission to acknowledge their own experiences without fear of judgment.

2. Use Real-World Examples from the Industry

Generic wellness advice rarely resonates with people working in high-pressure environments. A good keynote speaker tailors examples to the audience’s reality:

• The paramedic who goes home after a traumatic call

• The attorney who hasn’t taken a real vacation in years

• The mortuary worker who carries families’ grief long after the service ends

• The construction supervisor who feels responsible for everyone’s safety

When employees hear stories that reflect their world, they feel seen, and stigma loosens its grip.

3. Teach Practical, Evidence-Based Tools

People don’t need abstract theory (unless we’re at a professional conference, then let’s get nerdy about data, by all means!). The average employee in a tough industry needs strategies they can use tomorrow morning. Effective mental health keynotes include:

• How to recognize early signs of burnout

• How to set boundaries without guilt

• How to talk to a coworker who seems overwhelmed

• How to use recovery practices during long shifts

• How to access support without fear of retaliation

When employees walk away with concrete skills, they’re more likely to view mental health as a normal part of workplace functioning. This makes work sustainable and healthier for everyone involved.

4. Address Organizational Culture, Not Just Individual Coping

Stigma isn’t just an individual problem; it’s a cultural one. A strong keynote acknowledges systemic contributors:

• Chronic understaffing

• Excessive workloads

• Lack of psychological safety

• “Tough it out” norms (especially  present in first responders, law enforcement, military, and other high-trauma-exposure professions)

• Leadership burnout

When mental health speakers name these realities, employees feel validated rather than blamed. And leaders gain insight into how their policies shape mental health outcomes.

5. Model Vulnerability Without Oversharing

One of the most powerful ways to reduce stigma is for the speaker, and ideally the leadership, to model appropriate vulnerability. This doesn’t mean oversharing personal details, shifting focus to oneself, or trauma-dumping. It means acknowledging that stress, grief, and emotional fatigue are universal human experiences, and acknowledging these appropriately within a professional setting creates a healthy and authentic working environment.

When a respected professional says, “I’ve been there too,” the room shifts. People exhale. Stigma softens.

6. Create Space for Questions and Dialogue

The most impactful keynotes don’t end when the speaker steps off the stage. They spark conversations. Q&A sessions, small-group discussions, “homework” assignments to follow through on what was taught, and follow-up workshops help employees integrate what they’ve learned.

This is where stigma reduction becomes culture change.

7. Reinforce That Seeking Help Is a Strength

Employees in tough industries often believe they must be the strong ones for everyone else. A mental health-focused keynote that reframes help-seeking as a professional competency, not a liability, can be transformative.

When people understand that mental health care improves performance, safety, and longevity in the field, stigma loses its power. 

Mental health keynote presentations can be more than feel-good inspirational speeches; they can be catalysts for cultural transformation. When organizations choose speakers who understand the realities of high-stress industries and who deliver practical, compassionate, evidence-based content, employees walk away feeling empowered rather than judged.

Reducing stigma isn’t about forcing people to talk about mental health. It’s about creating environments where they can talk about it without fear, without shame, and without feeling alone.

And that’s where real change begins.

CREATE LASTING CHANGE WITH A MENTAL HEALTH SPEAKER IN LOS ANGELES, CA

Workplace culture can shift dramatically when leadership commits to addressing mental health stigma openly, but one-time initiatives or generic trainings rarely create a lasting impact. When organizations want real change—where employees feel safe seeking support and mental health becomes part of everyday conversation—a keynote presentation from a mental health speaker in Los Angeles, CA, who understands what actually works, can be the catalyst that transforms your workplace.

Recognizing when surface-level efforts aren't enough requires attention to meaningful indicators—high turnover among stressed employees, reluctance to use mental health benefits, silence around burnout and anxiety, or a culture where people only discuss struggles in whispers. These patterns signal that your organization needs more than policies on paper. They call for authentic, evidence-based communication that reduces shame, builds trust, and creates permission for people to prioritize their well-being without fear of judgment or career consequences.

As a trusted mental health speaker in Los Angeles, CA, Dr. Stacy Reger understands that stigma reduction requires more than awareness—it demands strategy, psychological insight, and genuine connection. Her approach to keynote presentations is research-informed, engaging, and responsive to the unique dynamics of your workplace. She helps HR leaders, executives, and teams move beyond checkbox compliance and create environments where mental health support becomes embedded in company culture. Dr. Reger's presentations ensure that your investment in employee well-being translates into real behavior change—not just temporary inspiration.

Take the next step toward a stigma-free workplace:

1. Call (424) 262-1925 to discuss how a keynote presentation can address your organization's specific needs

2. Book a mental health speaker in Los Angeles, CA who delivers evidence-based strategies that actually work

3. Create a workplace culture where mental health is normalized, supported, and genuinely valued

OTHER SERVICES DR. REGER PROVIDES IN CALIFORNIA

Beyond keynote presentations on workplace mental health, Dr. Stacy Reger offers a full range of psychological services and organizational consulting designed to support both individual well-being and systemic culture change. Her practice includes neuropsychological evaluations for adults and older adults, cognitive assessments, testamentary capacity evaluations, and pre-surgical psychological screenings for individuals navigating health and cognitive changes.

Dr. Reger also provides individual therapy for adults managing anxiety, depression, burnout, life transitions, and the emotional complexities of aging and caregiving. She works with professionals experiencing workplace stress, imposter syndrome, and perfectionism, as well as older adults and their families navigating grief, identity shifts, and difficult decisions around independence and care. Her therapeutic approach is warm, evidence-based, and tailored to each person's unique needs and values.

In addition to clinical work, Dr. Reger collaborates with organizations through customized workshops, leadership training on mental health management, panel discussions, and consultation services that help HR teams and executives implement authentic, effective mental health initiatives. She also provides educational presentations for community groups, professional organizations, and healthcare teams seeking to improve communication and reduce stigma around mental health and aging. For more guidance on workplace mental health, cognitive health, and navigating sensitive conversations, explore Dr. Reger's blog for additional insights and resources.

Signs That It Might Be Time for a Capacity Retest: When Past Evaluations Are No Longer Enough

Evaluations of decision-making capacity are often viewed as definitive answers. Families and professionals breathe a sigh of relief when a thorough assessment provides clarity. Yet capacity is not a fixed trait, it is fluid. A testamentary capacity evaluation, just like any psychological or neuropsychological evaluation, gives a snapshot of how someone is doing at one particular moment in time. Things like mental health, physical health, cognition, relationships, and environment change over time, and so can a person’s capacity. A past evaluation may have been accurate at the time, but it may no longer reflect the present reality.

As a geropsychologist, I have worked with families, caregivers, fiduciaries, and professionals in situations when a person’s capacity to make certain decisions has changed months or years after a previous testamentary capacity assessment. In these cases, there are signs that a capacity retest might be warranted. Here are some key indicators.

Cognitive Shifts That Raise Concern

• Memory decline: Increasing forgetfulness, difficulty recalling recent events, or repeating questions more frequently.

• Problem-solving difficulties: Struggling with everyday tasks like balancing a checkbook or following recipes.

• Communication changes: Trouble finding words, following conversations, or understanding written material.

This is the biggest (and most obvious) indicator that an updated capacity assessment may be needed. When cognitive changes appear or worsen, it’s a signal that the prior evaluation may no longer capture current abilities, and capacity may have shifted.

Medical or Psychiatric Changes

• New diagnoses: Conditions such as dementia, stroke, or depression can alter decision-making capacity.

• Medication adjustments: Some prescriptions may improve cognition, while others may impair it.

• Hospitalizations or acute illness: Episodes of delirium or complications can temporarily or permanently affect functioning.

Because health is dynamic, capacity assessments must sometimes be revisited when medical circumstances change. This is particularly true if one of the capacities in question is the capacity to make medical decisions about treatments, surgeries, or living independently after a health status change. 

Life Transitions and New Demands

• Changes in living arrangements: Moving to assisted living or nursing care often requires adapting to new routines. This is fine for many folks, but for some older adults with mild cognitive decline, a big change like this can overwhelm their ability to adapt.

• Increased independence needs: A person may suddenly need to manage finances or healthcare decisions on their own, for example, after a spouse passes away. Again, in some situations, this is fine. In other situations, for example, if the living partner never managed the finances at all, and now lacks capacity to do so alone, a capacity assessment may be needed.

• Caregiver observations: Family members or staff noticing difficulties in judgment or daily functioning that may impact decisions.

Capacity is context-dependent. What was adequate in one environment may not be sufficient in another, and an updated capacity assessment can clarify exactly how a person’s needs have changed.

Legal and Financial Considerations

• Estate planning updates: Drafting or revising wills, trusts, or powers of attorney requires clear capacity. For older adults wanting to make changes to a trust or will, it is often important to have a capacity evaluation even if a lack of capacity is not suspected. This protects any decisions from being contested in the future.

• Financial vulnerability: Susceptibility to scams, risky investments, or poor judgment in spending. A capacity assessment can give clarity about a person’s decisions, especially if they are being influenced or making questionable financial decisions that are out of character.

• Guardianship reviews: Courts may request updated evaluations to ensure protections remain appropriate.

Because these decisions carry lasting consequences, retesting ensures they are made responsibly.

Fluctuating Abilities

Some individuals experience “good days” and “bad days.” If functioning seems inconsistent, a retest can help clarify whether the person can reliably make decisions or if supports are needed, and if so, what type of supports would allow the most independence possible.

Why Retesting Matters

Retesting is not about questioning past evaluations; it is simply a reality that comes with the way people evolve over the lifespan. A new assessment ensures:

• Decisions are made with the most accurate understanding of abilities.

• Supports are tailored to current needs.

• Families and professionals can act with confidence and compassion.

Capacity evaluations are tools for empowerment, not restriction. They safeguard autonomy while protecting well-being. If you notice any of the signs above, consider consulting a qualified professional for a retest. Past evaluations are valuable, but they are not permanent verdicts.

GET UPDATED CLARITY WITH A TESTAMENTARY CAPACITY RETEST IN LOS ANGELES, CA

Cognitive abilities can shift over time due to illness progression, new diagnoses, medication changes, or life events. When a previous testamentary capacity assessment in Los Angeles, CA no longer reflects a person's current functioning, a retest may be necessary to ensure decisions remain legally valid and aligned with their true intentions. Whether months or years have passed, reassessment provides updated clarity that protects everyone involved.

Recognizing when past evaluations are no longer enough requires attention to meaningful changes—declining memory, confusion about key decisions, progression of dementia, or sudden medical events that impact thinking and judgment. These situations are never easy to navigate, but they call for updated professional insight that honors both the person's autonomy and the legal requirements surrounding estate planning.

As a trusted geropsychologist in Los Angeles, CA, Dr. Stacy Reger understands that capacity is not static. Her approach to capacity retesting is thorough, compassionate, and responsive to the realities of cognitive change. She helps families, attorneys, and fiduciaries determine whether a new evaluation is warranted and conducts updated assessments that reflect current cognitive functioning. Dr. Reger's work ensures that decisions made today are grounded in accurate, present-day understanding—not outdated information.

Take the next step toward updated clarity and protection:

1. Call (424) 262-1925 to discuss whether a capacity retest is appropriate for your situation

2. Schedule a testamentary capacity assessment in Los Angeles, CA with a geropsychologist who specializes in retesting

3. Receive a comprehensive assessment that reflects current cognitive abilities and legal standards

OTHER SERVICES DR. REGER PROVIDES IN CALIFORNIA

Beyond capacity retesting, Dr. Stacy Reger offers a full range of neuropsychological evaluations and geriatric mental health services designed to support families through every stage of aging and cognitive change. Her practice includes baseline cognitive assessments, dementia evaluations, pre-surgical screenings, and consultations that help families plan proactively rather than reactively.

Dr. Reger also provides therapy for older adults and their caregivers who are managing the emotional weight of cognitive decline, changing roles, and difficult decisions. She works closely with legal professionals, financial advisors, and healthcare teams to ensure coordinated care that respects both personal wishes and professional standards. Through education, training, and compassionate consultation, she helps families communicate more effectively and navigate uncertainty with greater confidence. For more guidance on recognizing signs of cognitive change and understanding when reevaluation may be needed, explore Dr. Reger's blog for additional insights and resources.