RESEARCH STARTER

Malingering

Malingering is the intentional act of feigning or exaggerating physical or mental illness for personal gain, such as avoiding responsibilities or obtaining financial benefits. This behavior can range from minor actions, like a child pretending to be sick to skip school, to more serious instances, such as adults exaggerating injuries to collect insurance payouts or evade legal consequences. Malingering differs from conditions where individuals misrepresent their health without intent, such as certain psychiatric disorders. The term originates from a mixture of German and French, meaning "wrongly weak," and has been recognized in medical literature since the early 19th century.

The identification of malingering can be challenging for healthcare professionals, primarily because they are generally trained to trust patient reports and prioritize legitimate medical concerns. Factors that may suggest malingering include inconsistencies in reported symptoms and lack of improvement with standard treatments. Suspected cases often lead physicians to conduct further evaluations, sometimes consulting psychiatric experts. Malingering can result in significant repercussions, including disciplinary actions in workplaces or schools, and potential legal consequences like fines or imprisonment. Moreover, it poses broader economic burdens by inflating healthcare costs and diverting critical resources from patients with genuine medical needs.

Full Article

Malingering is a medical diagnosis that refers to someone who makes up symptoms or exaggerates illness or injury to gain some reward. It can refer to something as simple as a child who pretends to have a stomachache to avoid going to school or as serious as someone who lies about injuries to get a large insurance settlement. Malingering means the person intentionally makes up or exaggerates the symptoms. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) does not classify malingering as a mental disorder but categorizes it under “other conditions that may be a focus of clinical attention.” It does not apply when the person is not intentionally describing symptoms inaccurately or when the person is pretending to be sick for the sake of being labeled an ill person. These can be psychiatric conditions that are different from the deliberate faking of illness that defines malingering.

Background

The word malingering is of French origin, meaning “wrongly weak.” It comes from the French prefix mal, meaning “wrongly” and haingre, meaning “weak.” The earliest recorded use of the word was in the early nineteenth century (around 1820), when it was mentioned in an English medical article. A few years later, a French physician reported it was possible to dose a person with ether, an early anesthetic, to determine if the patient was faking symptoms.

It is likely that people have pretended to be sick to avoid something undesirable or to earn some type of reward from nearly the beginning of time. The Bible and other works make mention of people who pretended to be grappling with mental health conditions to avoid consequences, and there are reports of people who faked being blind or lame to beg for money or hide from authorities. When the idea of paying people who were hurt and unable to work developed in the nineteenth century, reports began to surface of people who were faking injuries or falsifying the severity of their injuries to get payments through benefits similar to workers’ compensation.

The practice has also reportedly been used in war propaganda. During World War II (1939–1945), British planes dropped pamphlets that reportedly explained to German soldiers how they could fake injuries sufficient enough to have them placed on medical leave. Faking an illness or injury to avoid military service also occurs in situations in which soldiers are drafted or otherwise forced to serve, as opposed to enlisting or volunteering.

Overview

Many illnesses or injuries have a specific diagnosis that serves as a standardized identification of its cause and nature. Physicians use these when people are seen for a routine checkup or for some illness or injury. Sometimes, however, people are motivated to fake illness or injury by greed or to avoid some consequence. Malingering is the diagnosis used by physicians when people intentionally pretend to be sick or injured or deliberately pretend to be more injured or sick than they are.

Malingerers usually fake illness or injury for one of two reasons: to avoid something or to gain something. People might pretend to be sick to avoid doing something, such as going to school or work, or to avoid serving on jury duty or in the military. People also pretend to have illnesses, both physical and cognitive, to avoid being punished for crimes or to lessen their sentences. In addition, some people who have substance use disorder fake pain or illness in order to have access to prescription pain medications.

Another common reason to pretend to be sick or injured is for financial gain. Someone might pretend to be hurt to make an insurance claim or to be eligible for workers’ compensation or disability benefits. Sometimes, people who were legitimately ill or injured might intentionally pretend to not recover or to not recover as quickly as expected so they can receive more benefits or receive them longer than they should.

Sometimes, people exaggerate their condition because of a mental health condition and not for external rewards. This is called a factitious disorder imposed on self, which is generally considered less common than malingering.

Diagnosing malingering has historically been difficult. Since most people do not fake being sick, physicians assume that the people they see are legitimately ill and treat them accordingly. Their training and nature incline them to assume people are telling the truth, or something close to the truth, about how they feel. Medical practitioners also have to be concerned about the risks of ignoring symptoms or assuming that the person is pretending. As a result, malingering can be very difficult to detect when the person is doing it to avoid work or school. It is somewhat easier in situations in which the patient stands to gain financially or where there are legal advantages to being sick or hurt. One study found that up to 20-50 percent of people being evaluated for disability benefits and nearly as many seeking compensation for personal injuries were exaggerating or faking all or part of their symptoms. Another study estimated that 17 percent of individuals in forensic populations may exaggerate symptoms. This is compared with a smaller percentage of people who malinger without financial or criminal incentives for their behavior.

Factors that alert a physician to the possibility of malingering include inconsistencies in the patient’s symptoms or differences in how they describe symptoms, continued failure to respond to conventional treatments, and the patient’s lack of cooperation with treatment plans. When malingering is suspected, physicians will often repeat diagnostic tests to confirm symptoms, especially those such as urinalysis that are easier for a person to affect by adding something to the test substance. Once a physician suspects malingering, the next step is to turn to psychiatrists for help. Psychological evaluation can help to determine if the patient is being honest and to uncover personality disorders that lead to malingering behavior.

The consequences for malingering can be significant. The malingerer can face discipline from school or work, and could be found guilty of attempted or actual fraud. This can carry the risk of fines or jail time.

There are other consequences as well, many of which are not felt directly by the malingerer. Fake illnesses and injuries add billions of dollars to the cost of healthcare. It also increases the costs of determining when illnesses or injuries are falsified, making it more difficult for those with legitimate needs to get benefits. Malingering ties up medical resources that are then not available to others in need, especially limited beds in hospitals and other facilities. This can affect the health and safety of other individuals.

Physicians must balance these problems with the need to avoid falsely accusing a patient of lying. Doing so could prevent that patient from receiving needed care. It can also add a label to that patient’s record that could affect future care.


Bibliography

Alozai, U. U., and P. K. McPherson. “Malingering – StatPearls.” National Center for Biotechnology Information, 12 June 2023, www.ncbi.nlm.nih.gov/books/NBK507837/#_NBK507837_pubdet_. Accessed 18 Mar. 2026.

Bass, Christopher, et al. “Factitious Disorders and Malingering: Challenges for Clinical Assessment and Management.” The Lancet, 19 Apr. 2014, www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62186-8/fulltext. Accessed 18 Mar. 2026.

Bienenfeld, David. “Malingering.” Medscape, 21 Jan. 2025, emedicine.medscape.com/article/293206-overview. Accessed 18 Mar. 2026.

Cirino, Erica. “What Is Malingering?” Healthline, 18 Sept. 2018, www.healthline.com/health/malingering. Accessed 18 Mar. 2026.

Harper, Douglas. “Malinger.” Online Etymology Dictionary, www.etymonline.com/word/malinger. Accessed 18 Mar. 2026.

“Malingering: Background, Pathophysiology, Epidemiology.” Medscape, WebMD LLC, 21 Jan. 2025, emedicine.medscape.com/article/293206-overview. Accessed 19 Mar. 2026.

“Malingering.” Psychology Today, 20 Mar. 2019, www.psychologytoday.com/us/conditions/malingering. Accessed 18 Mar. 2026.

Marasa, Lauren H. “Malingering: A Result of Trauma or Litigation?” American Journal of Psychiatry Resident’s Journal, 1 Mar. 2018, psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2018.130304. Accessed 18 Mar. 2026.

Full Article

Malingering is a medical diagnosis that refers to someone who makes up symptoms or exaggerates illness or injury to gain some reward. It can refer to something as simple as a child who pretends to have a stomachache to avoid going to school or as serious as someone who lies about injuries to get a large insurance settlement. Malingering means the person intentionally makes up or exaggerates the symptoms. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) does not classify malingering as a mental disorder but categorizes it under “other conditions that may be a focus of clinical attention.” It does not apply when the person is not intentionally describing symptoms inaccurately or when the person is pretending to be sick for the sake of being labeled an ill person. These can be psychiatric conditions that are different from the deliberate faking of illness that defines malingering.

Background

The word malingering is of French origin, meaning “wrongly weak.” It comes from the French prefix mal, meaning “wrongly” and haingre, meaning “weak.” The earliest recorded use of the word was in the early nineteenth century (around 1820), when it was mentioned in an English medical article. A few years later, a French physician reported it was possible to dose a person with ether, an early anesthetic, to determine if the patient was faking symptoms.

It is likely that people have pretended to be sick to avoid something undesirable or to earn some type of reward from nearly the beginning of time. The Bible and other works make mention of people who pretended to be grappling with mental health conditions to avoid consequences, and there are reports of people who faked being blind or lame to beg for money or hide from authorities. When the idea of paying people who were hurt and unable to work developed in the nineteenth century, reports began to surface of people who were faking injuries or falsifying the severity of their injuries to get payments through benefits similar to workers’ compensation.

The practice has also reportedly been used in war propaganda. During World War II (1939–1945), British planes dropped pamphlets that reportedly explained to German soldiers how they could fake injuries sufficient enough to have them placed on medical leave. Faking an illness or injury to avoid military service also occurs in situations in which soldiers are drafted or otherwise forced to serve, as opposed to enlisting or volunteering.

Overview

Many illnesses or injuries have a specific diagnosis that serves as a standardized identification of its cause and nature. Physicians use these when people are seen for a routine checkup or for some illness or injury. Sometimes, however, people are motivated to fake illness or injury by greed or to avoid some consequence. Malingering is the diagnosis used by physicians when people intentionally pretend to be sick or injured or deliberately pretend to be more injured or sick than they are.

Malingerers usually fake illness or injury for one of two reasons: to avoid something or to gain something. People might pretend to be sick to avoid doing something, such as going to school or work, or to avoid serving on jury duty or in the military. People also pretend to have illnesses, both physical and cognitive, to avoid being punished for crimes or to lessen their sentences. In addition, some people who have substance use disorder fake pain or illness in order to have access to prescription pain medications.

Another common reason to pretend to be sick or injured is for financial gain. Someone might pretend to be hurt to make an insurance claim or to be eligible for workers’ compensation or disability benefits. Sometimes, people who were legitimately ill or injured might intentionally pretend to not recover or to not recover as quickly as expected so they can receive more benefits or receive them longer than they should.

Sometimes, people exaggerate their condition because of a mental health condition and not for external rewards. This is called a factitious disorder imposed on self, which is generally considered less common than malingering.

Diagnosing malingering has historically been difficult. Since most people do not fake being sick, physicians assume that the people they see are legitimately ill and treat them accordingly. Their training and nature incline them to assume people are telling the truth, or something close to the truth, about how they feel. Medical practitioners also have to be concerned about the risks of ignoring symptoms or assuming that the person is pretending. As a result, malingering can be very difficult to detect when the person is doing it to avoid work or school. It is somewhat easier in situations in which the patient stands to gain financially or where there are legal advantages to being sick or hurt. One study found that up to 20-50 percent of people being evaluated for disability benefits and nearly as many seeking compensation for personal injuries were exaggerating or faking all or part of their symptoms. Another study estimated that 17 percent of individuals in forensic populations may exaggerate symptoms. This is compared with a smaller percentage of people who malinger without financial or criminal incentives for their behavior.

Factors that alert a physician to the possibility of malingering include inconsistencies in the patient’s symptoms or differences in how they describe symptoms, continued failure to respond to conventional treatments, and the patient’s lack of cooperation with treatment plans. When malingering is suspected, physicians will often repeat diagnostic tests to confirm symptoms, especially those such as urinalysis that are easier for a person to affect by adding something to the test substance. Once a physician suspects malingering, the next step is to turn to psychiatrists for help. Psychological evaluation can help to determine if the patient is being honest and to uncover personality disorders that lead to malingering behavior.

The consequences for malingering can be significant. The malingerer can face discipline from school or work, and could be found guilty of attempted or actual fraud. This can carry the risk of fines or jail time.

There are other consequences as well, many of which are not felt directly by the malingerer. Fake illnesses and injuries add billions of dollars to the cost of healthcare. It also increases the costs of determining when illnesses or injuries are falsified, making it more difficult for those with legitimate needs to get benefits. Malingering ties up medical resources that are then not available to others in need, especially limited beds in hospitals and other facilities. This can affect the health and safety of other individuals.

Physicians must balance these problems with the need to avoid falsely accusing a patient of lying. Doing so could prevent that patient from receiving needed care. It can also add a label to that patient’s record that could affect future care.


Bibliography

Alozai, U. U., and P. K. McPherson. “Malingering – StatPearls.” National Center for Biotechnology Information, 12 June 2023, www.ncbi.nlm.nih.gov/books/NBK507837/#_NBK507837_pubdet_. Accessed 18 Mar. 2026.

Bass, Christopher, et al. “Factitious Disorders and Malingering: Challenges for Clinical Assessment and Management.” The Lancet, 19 Apr. 2014, www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62186-8/fulltext. Accessed 18 Mar. 2026.

Bienenfeld, David. “Malingering.” Medscape, 21 Jan. 2025, emedicine.medscape.com/article/293206-overview. Accessed 18 Mar. 2026.

Cirino, Erica. “What Is Malingering?” Healthline, 18 Sept. 2018, www.healthline.com/health/malingering. Accessed 18 Mar. 2026.

Harper, Douglas. “Malinger.” Online Etymology Dictionary, www.etymonline.com/word/malinger. Accessed 18 Mar. 2026.

“Malingering: Background, Pathophysiology, Epidemiology.” Medscape, WebMD LLC, 21 Jan. 2025, emedicine.medscape.com/article/293206-overview. Accessed 19 Mar. 2026.

“Malingering.” Psychology Today, 20 Mar. 2019, www.psychologytoday.com/us/conditions/malingering. Accessed 18 Mar. 2026.

Marasa, Lauren H. “Malingering: A Result of Trauma or Litigation?” American Journal of Psychiatry Resident’s Journal, 1 Mar. 2018, psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2018.130304. Accessed 18 Mar. 2026.

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