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In Atkins v. Virginia, the Supreme Court determined it was unconstitutional to sentence an intellectually disabled person to death. The determination of intellectual disability (ID), although a legal decision, is one that should be based on clinical information alone to protect the claimant’s constitutional rights. Research must clarify the role of heinousness based on the inclusion of the aggravating factor “especially heinous, atrocious, or cruel” in capital cases. The current study assessed how the heinousness of a crime impacts legal decision making in Atkins hearings (i.e., the determination of whether an individual qualifies for a diagnosis of ID). Participants were separated into two groups that differed in crime heinousness (low vs. high) and provided with a case vignette describing a crime, as well as an audio recording of a mock Atkins hearing. All clinical information pertaining to intellectual disability (e.g., IQ and adaptive behavior) were held constant between groups. Participants then determined whether the claimant was qualified for a diagnosis of ID and provided reasons for their decisions. The relationship between ID determinations and level of crime heinousness will be discussed in terms of clinical and legal applications.