Most healthcare providers are reticent to express frank opinions about a patient's symptoms that appear to be magnified, exaggerated, or feigned. Providers are fearful that blunt opinions may lead to retaliation against them by complaints to the State Board of Medical Examiners, claims of malpractice or accusations of bias in favor of the employer. Even if asked directly at hearing or deposition providers are often reluctant to express an opinion about the patient's credibility or sincerity of effort.
When you are reading a provider's report you should interpret the following terms to mean that the provider is saying that the patient's symptoms may not be legitimate: breakaway weakness; give-way weakness; nonanatomic; nonphysiologic; positive Waddell's signs; diffuse tenderness; subjective symptoms disproportionate to objective findings; inconsistent straight leg raising; stocking-glove distribution; inconsistent ranges of motion when distracted; exaggerated pain behavior; pain level report on the zero to ten pain scale inconsistent with presentation during examination; exquisite tenderness to palpation; numbness, pain or paresthesias in a nondermatonal distribution; psycho-social factors; diffuse myofascial dysfunction; absence of objective neurologic signs; somatization; and psychological factors.
The presence of one or more of these terms in a report does not necessarily mean that the patient is faking an injury, but it may mean that the patient has an agenda for secondary gain. Also, the absence of any of these terms in a physician's report does not mean the patient has legitimate complaints.  When the terms are there the claim should be scrutinized and surveillance should be considered. Keep in mind that most providers will generally believe the patient's symptoms. The provider's role is not to be a skeptic or investigator. On the other hand, honest providers will use euphemistic and medically couched terms to signal the reader of the report that the patient's symptoms are questionable.