Snapshot A 45-year-old man comes to your office complaining of severe back pain. This is his fourth visit in 2 months. You offer a orthopedic surgery consult which he denies. He has asked you each visit if you would sign a form to receive long-term disability compensation. After much debate during this visit, you decide to sign the form. The patient does not return to your office again. Introduction Clinical definition patient consciously fakes illness in order to attain secondary gain e.g., claim disability compensation, attain drugs patients will avoid treatment Presentation Symptoms vary based on complaint PROGNOSIS Complaints stop once secondary gain is obtained