Record that a clinical-validity attestation was, or was not, true.

A HUMAN DECIDES, ALWAYS. There is no sweep, no heuristic and no model that writes this: the whole reason the attestation moves responsibility is that a named person looked at the case and reached a conclusion, and an automated finding would be an automated pay cut, which this codebase already refuses to make (see the quality-hold branch in payments.reconcile_task_accruals).

The payment consequence is not applied here. It is applied by the accrual sweep reading validity_finding, which is what makes it idempotent, makes it survive a finding recorded before the ledger row exists, and keeps the one rule about restating settled money in the one module that owns money.