Physicians performing impairment evaluations on patients with cognitive complaints and possible central nervous system disorders should perform a clinical mental status assessment. Assessing cognitive complaints efficiently, in a systematic and supportable way, can be challenging. The AMA Guides to the Evaluation of Permanent Impairment specifies that objective criteria are important to consider when assessing impairment. Physicians may choose to use standardized cognitive screening tests (cognitive screeners) as a relatively quick, practical tool to initially assess patients and aid in decision making. Several cognitive screeners will be discussed in detail below. A patient's performance on such tests may indicate that more comprehensive testing is needed. Cognitive screeners have limitations and are not designed to assess symptom validity or the extent to which psychological factors may contribute to cognitive complaints. Comprehensive neuropsychological assessment may be indicated in these situations and when the screeners demonstrate findings of potential concern help define MMI.