This paper describes the interview process, the assessments, report writing and potential giving of testimony involved in an occupational therapy medico-legal service for chronic pain patients which is provided for lawyers, insurance companies and other community agencies. The programme is available through the occupational therapy department at McMaster University Medical Centre of Chedoke-McMaster Hospitals, Hamilton, Ontario. The assessment process is delineated, including descriptions of the initial interview and functional assessment using both standardized and non-standardized tests, a self-monitoring diary, a home visit, a job site visit, and a work placement. Potential treatment recommendations are outlined. The content of the medico-legal report is examined utilizing personal experience and current literature and recommendations for testimony are explored.