“The following facts and circumstances tend to establish that the plaintiff is not malingering but is suffering actual pain: Complaints of pain, tenderness, or soreness; Distorted facial appearance indicative of sadness, depression, or prostration; Malnutrition consistent with long-continued pain if of severe degree; Pallor; Tears or signs of weeping, such as redness of eyes; Trembling or faintness; Excessive perspiration; Reaction to application of sudden pressure to painful area, where no possibility of self-inflicted pain, such as biting tongue is present, resulting in: Dilation of eye pupils, sudden change of facial expression, increase in pulse or respiratory rate, rise in blood pressure; Absence of response to manipulation in area of body not normally associated with injury, indicating proper restriction of painful symptoms to injured area; Spasms of individual muscle bundles in associated areas; Abnormality of reflexes; Laboratory tests consistent with painful symptoms; Type of injury ordinarily accompanied by pain; Objective signs of pain even when patient does not know he is being observed; Cessation of painful complaints upon receiving analgesic drugs.”
[Stein on Personal Injury Damages [certain citations omitted]]
