Secondary gain is a psychological term that refers to a motivating factor that a patient has in reporting symptoms or complaints of pain. More simply put, secondary gain is an outside reason or benefit to complain of pain or symptoms. For instance if you tell your doctor “I think I broke my arm because the bone is sticking out of my skin” you obtain medical treatment. You also have a secondary gain in that you may get paid time off of work or even a little extra attention from your family.

The phrase secondary gain in its accurate use does not imply that the patient even recognizes or realizes the gain that is being given to them. Specifically, it does not require or include any type of conscious thinking on the part of the patient.

Unfortunately, in workers’ compensation circles the term secondary gain is often interchanged with the term malingering. Malingering involves an intentional lying about a condition in order to obtain benefits. In a workers’ compensation claim malingering can, and obviously should, be avoided but secondary gain cannot be. That’s why we are offended when rehabilitation nurses and some doctors roll their eyes when they use the term secondary gain. Many of them act like you receiving surgery to repair an injury you suffered due to your employer’s negligence is a sign that you’re a bad person. We think that is unfair.