Primary gain and secondary gain, and more rarely tertiary gain, are terms used in medicine and psychology to describe the significant subconscious psychological motivators patients may have when presenting with symptoms. It is important to note that if these motivators are recognized by the patient, and especially if symptoms are fabricated or exaggerated for personal gain, then this is instead considered malingering. The difference between primary and secondary gain is that with primary gain, the reason a person may not be able to go to work is because they are injured or ill, whereas with secondary gain, the reason that person is injured or ill is so that they cannot go to work.