Objective: This retrospective study was designed to examine an embedded validity indicator for the Rey Auditory Verbal Learning (AVLT) developed by Davis, Millis, and Axelrod (2012). Using a large clinical sample the sensitivity and specificity of this index was evaluated. Method: A sample of 420 English speaking patients with suspected dementia were examined. The patients were evaluated as part of a routine clinical neuropsychological evaluation at a major academic Midwestern Medical Center. The participants presented with either complaints of cognitive dysfunction related to memory, a change in mental status or with a psychiatric illness. The patients were divided into 5 groups based on their scores on the St. Louis University Mental Status Exam (SLUMS, Tariq et al., 2006). The retrospective collection and analysis of this archival data was approved by the Institutional Review Board. The sensitivity and specificity of the AVLT embedded index were examined using XLSTAT Version 2013.1.02 Life Module. Results: This study provides the cumulative percentage of index scores for the 5 study groups. Additional data analysis showed that the new index is specific but not sensitive in detecting adequate effort. In the mild cognitive impairment group, the index classified all of the patients as having put forth adequate effort. The sensitivity and specificity of the moderate and severe cognitive deficit groups are also described. Proposed cut off scores (including PPV ad NPV) using the 5 base rates as measured by the SLUMS are provided. Conclusion: The study provides clinical base-rates and cut-offs for the new index. It also shows that in some cases the new index misidentified a large group of subjects who exhibited intact effort, particularly among patients with severe cognitive dysfunction. Several limitations of the current study should be mentioned. The study does not include a control group of individuals who were claimants nor did it control for response bias.