REWARD Report Pairing process with presence.

The Middle Way: Where Process Meets Partnership

by Mitch Pousson

Workers’ compensation involves many moving parts. Too many to cover in a single article.

After nearly 25 years as a case manager, I appreciate the steady efforts and roles of everyone involved: adjusters, physicians, therapists, employers, attorneys, case managers, the Bureau, injured workers, and likely a few others I unintentionally left out. Thank you to those who continue to approach this process with professionalism, clarity, and care. When each stakeholder brings focused attention and empathy, the system functions as it was intended—to restore, not just to reimburse.

to restore, not just to reimburse.

At its best, workers’ compensation is both a structured process and a working partnership. It is this balance that allows real recovery to take root.

REFRAMING THE FRAMEWORK

Workers’ compensation is often built around transactions: compliance, documentation, and deadlines. These components provide fairness and accountability. However, if we stop at structure, we risk reducing recovery to paperwork.

What if we maintained the structure and shifted our mindset from injury management to worker wellness?

The transactional side ensures impartiality. But as Pransky, Snyder, and Dembe have observed, recovery is more effective when we integrate principles from adjacent fields such as behavioral health and rehabilitation. These disciplines emphasize the importance of personalized, relational support during the return-to-work process.

We don’t need to discard the system. We need to evolve it. We can preserve its integrity while embracing the human factors that lead to better outcomes.

NAVIGATING THE SPACE BETWEEN

Every claim exists in the space between structure and compassion. One side gives us rules that provide stability. The other side creates space for responsiveness and healing.

A structured system keeps timelines and expectations in place. A collaborative approach listens, adapts, and centers the person—not just the injury.

Empathy does not weaken the system; it moves it forward. When we pair process with presence, we do more than close claims. We support recovery.

“A healthy person has a thousand wishes. A sick person only one.”

A PERSONAL PERSPECTIVE

On January 31, 2025, I rolled my ankle during an early morning run. An MRI confirmed the damage: a high ankle sprain involving three torn ligaments. For the first time, I was not the case manager. I was the injured worker.

The experience deepened my appreciation for the workers I have assisted over the years. Every delay, every unknown, every missed call—they feel it. When stakeholders and caregivers respond with flexibility and empathy, it changes everything.

I was fortunate. I work for a generous company, where leadership values people. I was given the time, trust, and space to recover. I remained productive, but more importantly, I felt supported throughout.

RECOVERY IS NOT LINEAR

Healing is not a straight line. Progress fluctuates. One day brings strength. The next may bring pain, swelling, stress, or setbacks. That is not failure; it’s reality.

Research supports what we’ve seen anecdotally for years. Factors such as mental health, stress, and emotional resilience significantly influence the course and cost of recovery. As Christian, Wickizer, and their colleagues have shown, claims involving coexisting mental health conditions often result in increased disability duration and higher overall costs. We learn to meet people where they are, not where we think they should be.

When we accept the non-linear nature of healing, we become better partners in the process. We shift from trying to control recovery to supporting it. We respond instead of react.

THE CLAIM IS NOT THE PERSON

We don’t have to choose between structure and compassion. The most effective systems hold both.

Process ensures consistency. Empathy ensures connection. One keeps us compliant. The other keeps us human.

Compassion isn’t a single gesture. It’s a posture. It’s how we stay open, present, and suspend judgment. It’s asking, not assuming. Listening, not just informing. It invites the injured worker to take an active role in their recovery, seen not as someone broken to fix, but as someone with insight and agency in their own healing.

Compassion is the willingness and capacity to let someone know they are supported throughout the recovery process.

As partners in a multi-faceted system, we share a responsibility to create the conditions that allow healing to occur. Every interaction is an opportunity to affirm that the injured worker is not a problem to solve, but a person to support.

When process and partnership work hand in hand, we do more than help people get back to work. We help them get back to wellness.

REFERENCES

Pransky, G., Snyder, T., & Dembe, A. (2015). Improving Return-to-Work Research and Practice: What Can We Learn from Other Fields? Journal of Occupational Rehabilitation, 25(1), 3–9. https://doi.org/10.1007/s10926-014-9512-2

Christian, J., Wickizer, T. M., Burton, J., Wang, H., & Franklin, G. (2010). Health Care and Disability Costs of Workers’ Compensation Claims with Coexisting Mental Health Conditions. Journal of Occupational and Environmental Medicine, 52(6), 609–615. https://doi.org/10.1097/JOM.0b013e3181de867f

ABOUT MITCH POUSSON

Mitch Pousson, RN, CCM is the Director of Workers’ Compensation at Tennessee Orthopedic Alliance. With over 25 years of experience in case management and a clinical background in emergency and trauma nursing, Mitch leads TOA’s expansion efforts in the workers’ compensation space across Tennessee. He is a bilingual advocate for collaborative, restorative approaches to injury recovery, aiming to reframe workers’ comp as a pathway to wellness rather than just reimbursement.

R.E.W.A.R.D. PROGRAM: RETURN EMPLOYEES TO WORK AND REDUCE DISABILITIES

Early return to work benefits the employee with a faster recovery, staying in the routine of working, maintaining workplace relationships and skills, and enhanced self-worth. Physicians should practice effective, empathic communication strategies to help injured workers understand the benefits of early return to work.

- J. Mark Melhorn, Editor AMA Guides to Disease and Injury Causation

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MEET WITH LIKE-MINDED EMPLOYERS

Join us for the next virtual meeting on Tuesday, October 21, 2025 at 1 PM (Central Time). Rob Townsend will talk about waiting for the release to work: information gaps in allowing for a return to full-time or full-duty employment.

Disclaimer: Views expressed in the REWARD Report are solely those of the authors and may not reflect the official policy or position of the Tennessee Bureau of Workers’ Compensation, the Tennessee Court of Workers’ Compensation Claims, the Tennessee Workers’ Compensation Appeals Board, or any other public, private, or nonprofit organization. Information contained in the REWARD Report is for educational purposes only.