Clare Cole is an Occupational Therapist with nearly 17 years of clinical experience, who now works as an Expert Witness in the medico-legal field. Specialising in neurological occupational therapy, Clare takes on cases spanning stroke, brain injury, cauda equina syndrome, and personal injury. Here, she shares how she found her way into the role, what she loves about it, and what she wishes she had known at the start.
I came to Expert Witness work through an unexpected change of circumstances.
I was on maternity leave from my role as Rehabilitation and Therapies Lead at a small neuro rehab unit when I was told that significant changes were being made to my role. So I started looking around, joined LinkedIn, and was contacted by Harrison Associates, a rehabilitation consultancy providing Expert Witness services, who I still work with.
Once I had found a new part-time NHS role, I started building up Expert Witness work alongside it.
The Expert Witness work gave me the cognitive challenge and sense of career progression that my day job – a more junior role than I had been doing – wasn’t quite providing. It also offered something different to NHS work: the time to do a thorough assessment, to sit with someone in their own home, and to be genuinely listened to by the legal team and other Experts. I’ve been doing it for about four years now, and for the past year I’ve been working fully freelance.
My clinical background is stroke and neurology, but the cases I handle are broader than that.
I work on clinical negligence cases, brain injury claims, cauda equina and other spinal cases, and personal injury claims with an orthopaedic focus. I’ve also had several Erb’s palsy cases, looking at how the injury will affect someone across their lifespan.
As an Occupational Therapist, clinical reasoning is the core skill.
You don’t need to know the exact detail of every surgical procedure – what you need to understand is the functional impact. What can this person do? What can’t they do? How does that affect their daily life? That’s what I’m there to assess.
Independence as an Expert Witness is something I take very seriously.
I aim to maintain roughly a 50/50 split between claimant and defendant instructions. It keeps me grounded and helps me maintain that independent mindset.
Expert Witnesses are there for the court, not for the party who has instructed us.
When I’m instructed by the defence, I might be asked to comment only on what’s been claimed. But if I feel something important has been missed – something that, left unaddressed, could mislead the court – I go back to the instructing solicitor and raise it. The most frequent pushback I encounter is from claimant solicitors pressing on rates or asking whether I’ve been generous enough.
But there are times when a barrister or solicitor will point out something useful – a different perspective, a service I hadn’t come across, a rate that warrants a second look. I’ll always consider that.
There’s a difference between updating your view in light of new information and simply bending to pressure. If I’ve discarded something for a clear reason, I’ll explain that clearly.
Coming from the NHS, the biggest mindset shift is learning to think without limits.
In the NHS, everything is constrained. You work within those boundaries because you have to. In the medico-legal world, you leave all of that at the door. The question is: what does this person need? What would restore them to how they were before this happened? You take a kind of magic wand to the problem and figure out how to fix it. That’s why I love it. It’s a massive puzzle.
The language of report writing took real adjustment.
In the NHS, we tend towards soft, hedged language. “This person would benefit from...” or “It might be helpful to consider...”. As an Expert Witness, that won’t do. You need to be direct: “They need this.” and “This is required.” It sounds like a small thing, but it fundamentally changes the tone and authority of a report.
You also have to strip out all emotional language. I would never write “unfortunately” or “tragically” in a report, even when what I’ve read is genuinely distressing. The report must be measured, factual, and objective.
Meeting the individual is almost always essential.
In the vast majority of cases, I need to meet the person at the centre of the case. Records are limited: I need to see how someone moves around their property and watch them do things. The nuance is in the observation, not the paperwork.
I never know how a case will end – and I rarely find out.
In four years, none of my cases have gone to trial, all settling during the run-up to court. But I approach every single case as though it will. Every recommendation must be defensible in front of a judge. That rigour is what keeps the standard high.
When a case closes, I receive an email simply saying the matter has concluded, please send in any outstanding invoices. As Experts, we contribute to a process and then let it go. It’s a strange feeling – not entirely unlike discharge from a clinical role, but without even the knowledge that you’re leaving them in a good place.
The support of an established company has been invaluable.
Harrisons handles all enquiries and communications with solicitors and the office team manages calculations, formatting, and administrative tasks. There is always someone to ask when something feels uncertain. When you’re new to Expert Witness work, that safety net matters enormously. The support is there at every stage.
There is also a solicitor in-house who reviews every report before it goes out – an extra perspective to ensure our reasoning is clear and pointers on what the legal team might need, as well as advice on case law.
The learning never stops – and that’s one of the things I love most.
One of the privileges of Expert Witness work is being in conferences with world-renowned specialists – a neurosurgeon, a rehabilitation consultant, an orthopaedic surgeon – explaining their research, their clinical reasoning, the nuances of a particular condition. I might have five other people in the room with me and we’re all learning together. That doesn’t happen in most jobs.
Sometimes I find myself disagreeing with one of those Experts, which is a challenging position to be in. But if the evidence points clearly in one direction, you have to say so. That’s what independence means.
My advice to any Occupational Therapist considering this path: go for it, but know what you’re taking on.
The reading volume is significant. You can have thousands of pages of medical records to work through, and you need to be able to skim them efficiently – identifying what matters, filtering out what doesn’t.
The flexibility is genuinely excellent. I do most of my report writing in evenings and at weekends, fitted around childcare and other commitments. The assessments and conferences are scheduled in advance, and once you’re working freelance, you have real control over your diary.
It can be slow to get started. With Harrisons, I went through a recruitment process, training, a mock case, and then a period of building up to my first real instruction. The early reports take much longer than they should, and the feedback can feel relentless. But stick with it! By around the sixth report, I started to find my footing. And now, I can say being an Expert Witness is one of the most intellectually rewarding things I’ve ever done.