A few weeks ago I saw a patient, a woman educated at university overseas, who took on an administrative role upon coming to Australia. She developed non-specific arm pain, which was then complicated by a disjointed approach in which her employer and the workers' compensation system responded with an underlying tone of distrust.

Her non-specific musculoskeletal problem became a sore arm along with a lot of uncertainty and a moderate level of distress. She was at that point where you sense things are not going well, but have not been quite able to articulate the issues and understand what you are dealing with. That type of situation where you have conversations in your mind over and over, and often at 3am when you should be sleeping.

Once her problem was reported at work she was advised to follow the defined path set up by her employer. This led to her going to her doctor. She then felt obliged to follow the defined path set up by her doctor, and then the defined path set up by her physiotherapist.

Along with concerns about her condition, she had an underlying sense of guilt about what she was not doing to look after her family, and about not being at work.

Her parting comment was that in her home country they didn't have a compensation system. She said her employer would have paid for her treatment and she would have worked out how to modify her job. She was sorry she had chosen to report her condition.

It is not an isolated case.

We've made things so complicated that trust from the system is missing. A system that was set up to improve outcomes for people with work-related health conditions is often convoluted and complex, and workers who are part of the system lose control.

Simple, common sense approaches have yielded to a system of rules and the decisions of those distant to the situation.

Patient-centred care, employee-centred care, claimant-centred care (depending on your bent) is not at the heart of our system.

Yes, it is hard to provide care that balances the needs of the employee and the needs of the employer, and yes it is difficult to deal with difficult people. And yes, there is a small percentage of claimants who use the system inappropriately.

But when our system deals with a long-term employee previously well regarded, in a process-focused approach that alienates them, it's time to question whether they would actually are better off without a compensation system.