By understanding brain function and dysfunction the neuroradiologist can contribute to some elements of the assessment a defendant’s competency to waive Miranda rights, competency to represent oneself in court, competency to stand trial, and competency to be sentenced. Each of these capacities, as well as other competency assessments, are task specific; if a specific brain dysfunction is reported as the cause of a lack of capacity, it may be further demonstrated, and its severity appreciated, by brain imaging. Using computer tomography (CT), magnetic resonance imaging (MRI), positron-emission tomography (PET), and ultrasound tests, The Forensic Panel’s neuroradiologists customize their testing and assessment protocols to the specific nature of each case to address the nuances reported from other clinical information, rather than to add hazy generalities without context. The forensic neuroradiologist can also more closely assess issues of competency that explore diagnoses from neurological impairment due to the effects of injury, disease, alcohol or drug use. An evidence-based assessment, combined with the oversight of peer-review, enforces the highest levels of integrity and ensures that imaging testimony respects the limits of progress in neuroimaging.