Benefit seekers/ malingerers

3 posts in this topic

every now and then you come across patients who you suspect are feigning symptoms in order for some kind of secondary gain- typically benefit payments 

recently I assessed a chap referred by his GP. During the review he was very vague about his symptoms - the usual "I'm hearing voices" but unclear about content and no objective evidence. He then spoke of vague symptoms of anxiety and depression but again was vague. The warning bells sounded when he passed a note saying he needed a report from myself to claim PIP. In addition he has received prison sentences in the past for 'fraud' and 'deception'. In addition he disliked me asking him questions about his problems continually saying things such as: 'you're the doctor- I need my nut sorting'


such patients put you in a very awkward position. I never quite know what to do with them as at the back of my mind I'm cautious to label them as malingering

what do others do?!!

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I have seen a similar case today

even if they are malignering

there is a level of anxiety in the background and affective symptoms

elicit those

if you are not sure about these tricky cases ,discuss them with team or a collegue

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Where I work, if we're asked to do a PIP request for a patient who's only been seen once, we'd generally explain to the patient that as we've only met them once, we can't provide the level of information they would require for a detailed report. If someone is in dire need of help with money, they can get support and advice through services like the citizens' advice bureau and Money Matters, or they can ask their GP to fill it in. If people are insistent or send the paperwork anyway (sometimes without asking...), one option is to complete the form explaining that the team doesn't know enough information to provide a report - there's a section on the form that allows you to say that you aren't able to provide a report on the issues in question - and if you're going to be seeing the patient again, you can always put on the form that you'd be willing to complete a report in the future, once you've been able to assess the patient more fully.

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