The Featherbedding Files, Entry 18. On “Malingering,” 1920

In  Bulletin of the Department of Labor and Industry (Commonwealth of Pennsylvania) Clifford B. Connelley, Commissioner. Containing: Proceedings of Annual Pennsylvania Safety Congress. Volume VII. Series of 1920. No. 4.

The Problem of the Malingerer

By Judson C. Fisher M.D.

Specialist in Industrial Insurance, New York City

 

No state or government has discussed workingmen’s compensation acts without at some time during the discussion someone has raised the problem of the malingerer.

… Suffice it to say, however, that there is a real problem as every industrial surgeon recognizes

As long as there is human nature so long will there be malingerers

As long as red-blooded men exist they will decry and seek to eliminate the man who lacks moral backbone and prefers to live at the expense of society

The problem is his detection and eradication. Malingerers were a problem in biblical history and they are a problem today.

The weakness which leads a workman to take advantage of benefits to which is not rightly entitled is seen in the business and professional life also… Our problem, therefore, is one of nature.

There are two classes of malingerer—real and exaggerators. A real malingerer is a real crook and should be condemned as such—that is the result of the ‘survival of the fittest’ instinct

The real malingerers are about one in 200, in my experience, among all classes, and 30 percent, among Italian and Polish longshoremen. Approximately 100 percent of their attending doctors are unscrupulous.

The exaggerators are those who have a legitimate accident, and after deriving benefits for a legitimate period for their types of accidents they malinger and prolong disability so as to get all they can.

This class is about 25 percent of all accidents and 70 percent of longshore cases, in my experience.

About 99 percent of all longshoremen “are out to get all they can get” (198)

… “there are various other causes for malingering which throw some light on these moral cowards”

Malingering is common in the Italian and Polish races. Someone has said that elimination of foreigners will go far towards solving the problem. My study… has convinced me that it is not necessarily the foreigner, but the vultures who prey upon them.

(…)

Mentally, I class malingerers as abnormal—they are out of touch as it were. Revenge, ambition for sympathy and alms, mimicism, fanaticism, or manic-depressive psychoses, combined with cunning, is the final analysis in nearly ever case.

The greater number of malingerers are among the less educated—we might say—the less civilized. The present social unrest has unstabilized the minds of many and they desire the life of ease at anyone’s expense.

The employer may give benefits in addition to the legal benefits. This aids malingering because the workman is sometimes making as much while idle as when working…

Malingerers tend to lower the moral atmosphere.

…Such a man is a moral leper in a group of workmen.

A malingerer in a group of workmen means that he will do haphazard work.

He will by his example lower the standard of efficiency among those about him.

There are always those who imitate the man who seems to be getting away with something.

This results in a lowering of production and increased cost of production (199)

 

To detect malingerers will be one method in the groping around for methods to reduce the high cost of living

Malingerers who are working are classed as lazy, but in fact they are afflicted with ergophobia as long as they can receive enough to exist upon.

(History of malingering as a medical concern: recent changes in law).

Workmen’s compensation, however, has brought the new viewpoint, that of returning the injured employee ot work in the shortest time with the best possible surgical results, but in addition having in mind the ability of the injured to resume work.

(…)

The malingerer rubs salt in his skin, makes false bruises, ties tight bandages above to cause innocent edema of the arms and legs, plasters on the back, and hundreds of devices for the simulation of injury that the cunning and unscrupulous doctors have taught and demonstrated in order to fool the industrial surgeons.

(…)

No one objects to assuming his just burden of cost or taxes. Likewise no American desires to assume the burdens imposed by a malingerer. He sees no reason why the malingerer at the expense of society should draw benefits to which he is not entitled.

(202)

 

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