Balanced Engagement: Navigating Activity and Surveillance
In July, we address the delicate balance of staying active and engaged while being mindful of potential surveillance by insurers in long term disability claims. At Riemer Hess, we appreciate the importance of living your best life within your restrictions and limitations, and we're here to guide you through navigating this balance.
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Did You Know?
July is Disability Pride Month
July’s Insights: Strengthening Support Networks
July marks Disability Pride Month, celebrating the passing of the Americans with Disabilities Act (“ADA”) in 1990. This month, we honor the progress made in recognizing and upholding the rights of individuals with disabilities. Riemer Hess is dedicated to championing these rights, with a special focus on advocating for individuals navigating long term disability claims. While we celebrate the strides made toward greater understanding and accommodation of disabilities, we remain aware of the ongoing challenges in achieving true equity for all.
Q: How can I build or strengthen my support network during the disability claim process, and what impact can it have on my well-being?
Building a strong support network is crucial during the disability claim process. As shared by our clients, staying positive and avoiding negativity is essential due to the significant bias often faced by disabled individuals. A supportive network can provide encouragement and strength, helping to navigate the challenges of the claim process.
Engaging in hobbies that align with your abilities, like light gardening, can bring joy and a sense of accomplishment within physical limits. Similarly, participating in manageable social activities helps maintain connections and social engagement without compromising health, striking a balance between staying connected and managing your condition.
As we commemorate Disability Pride Month, let's continue to support and uplift one another, advocating for a society where everyone is valued and empowered. Together, we can make a difference and ensure that the journey toward equity and inclusion progresses further.
Honoring Mindful Engagement
Our "Resilience Spotlight" is not just an award—it's a recognition of the remarkable courage demonstrated by members of our community. Each story highlights resilience and the remarkable strength of the human spirit.
Each month, our team selects a client who has not only faced their challenges head-on but has also actively contributed to or benefitted from community support. This spotlight is a testament to the power of collective strength and encouragement.
This Month's Inspiration: Emily (anonymous)
In this month's Client Connect newsletter, we are honored to spotlight Emily, an inspiring individual who faced significant challenges with her disability claim, including surveillance, yet demonstrated remarkable strength and adaptability throughout her journey.
Our client, “Emily,” a high-level professional, experienced a significant life change following a severe accident that left her with multiple injuries requiring extensive back surgeries. While her insurer initially approved her long term disability benefits, they were terminated prematurely, just a month before a critical change in the definition of her disability was to take effect. The insurer used surveillance to justify their decision, portraying Emily's sessions with a personal trainer as evidence of her physical capability. Of course, the insurer’s surveillance did not capture the whole picture. Their reliance on the footage failed to consider that these sessions were a prescribed part of her recovery, not an indication of her ability to work.
Emily’s personal trainer had carefully adapted her exercises to accommodate her condition, ensuring she avoided squatting, limited overhead exercises, and exercised barefoot when necessary. The trainer also adjusted her workouts based on her daily physical state, helping her stay motivated in a controlled environment that promoted consistency and commitment. Emily’s physical therapist had also recommended biking as an excellent non-weight-bearing exercise, allowing her to maintain a range of motion without exacerbating her injuries. These activities were part of her therapeutic regimen, crucial for her rehabilitation, and did not reflect an ability to return to her demanding professional role.
Riemer Hess intervened by obtaining Emily’s complete claim file and analyzing the surveillance footage in detail. We had Emily’s doctor review the footage to provide a medical perspective, emphasizing the therapeutic nature of her activities. Additionally, we referred Emily to a vocational expert and arranged for a Functional Capacity Evaluation (“FCE”), the results of which were endorsed by her surgeon. By meticulously addressing the nuances of her condition that the surveillance did not reflect, we successfully challenged the insurer's decision and reinstated Emily's benefits. As a result, Emily, who was deeply committed to her journey to recovery, continued receiving the financial support she needed.
Disability does not always mean a complete inability to engage in any activities. Surveillance conducted by insurers is often taken out-of-context to twist the narrative. However, there are ways to push back against this by providing thorough medical documentation and expert evaluations that offer a comprehensive view of your condition. It’s important to maintain your interests and hobbies, however limited, as these activities can significantly contribute to your well-being and recovery, especially when undertaken within your capability and as recommended by your doctors.
Balancing Engagement with Surveillance Awareness
Navigating life while potentially under surveillance by insurers can be challenging. Here are some tips to balance engagement in activities with the awareness of surveillance:
- Understand and Respect Your Limitations:: Familiarize yourself with the medical restrictions your condition imposes and plan your activities within these boundaries. It's crucial to stay within the limits set by your healthcare provider to avoid disputes with insurers.
- Choose Activities Wisely: Engage in activities that are consistent with your documented limitations. Activities should not contradict what you've communicated to your insurer about your disability. It’s important to avoid situations that could be misinterpreted by surveillance.
- Keep Records: Documenting your daily activities can be beneficial. If your activities are ever questioned, you have a record showing how they fit within your medical restrictions and limitations. This can be especially useful if there's a need to explain your actions to your insurer.
These tips are designed to help you lead a fulfilling life within your limitations while maintaining transparency and integrity in your disability claim. Remember, it's about finding a balance that allows you to live your life fully but also responsibly in the context of your claim.
Finding the Right Balance in Challenging Circumstances
In July, as we address "Balanced Engagement: Navigating Activity and Surveillance," it's crucial to find resources that help our clients balance their activities within the limitations of their disability, while being mindful of potential surveillance. We recommend a book that offers perspective on managing life's complexities with balance and awareness.
“Boundaries: When to Say Yes, When to Say No To Take Control of Your Life”
by Dr. Henry Cloud and Dr. John Townsend
About the Book: "Boundaries" by Dr. Henry Cloud and Dr. John Townsend is a guide on establishing and understanding personal boundaries. The book discusses how to set healthy boundaries with family, friends, and in work situations, which can be particularly helpful for individuals navigating sensitive issues like disability claims and insurance surveillance. It offers insights into when to say yes and how to say no, empowering readers to manage their lives more effectively.
Why It’s Relevant: For clients in long-term disability claims, understanding and managing boundaries can be a vital skill, especially when considering the potential of insurance surveillance. The book provides guidance on maintaining personal well-being and privacy while navigating external pressures and expectations. It's relevant for anyone who needs to carefully manage their public and private life due to health and legal considerations.
Why You Might Find It Inspiring: "Boundaries" helps readers to develop the confidence to manage their lives within their own terms, which is especially important in the context of disability claims. The book’s approach to setting and maintaining boundaries can inspire clients to find a balance between staying active within their limitations and being cautious of how their actions might be perceived by others.
As we explore balanced engagement this July, let "Boundaries" be your guide in navigating life's challenges with confidence and self-awareness.
August: “Preparing for Hearings or Meetings”
Riemer Hess wants to know: What are your key preparation tips for important hearings or meetings related to your disability claim?
Share your insights anonymously by clicking the Microsoft forms link below.
Embracing Balance in Activity and Awareness
This July, let’s find the right balance between staying active and being mindful of insurance surveillance. Riemer Hess is committed to supporting you in this balancing act, ensuring you live a fulfilling life within your limitations.
Looking Ahead to August
In August, we'll explore "Navigating Insurance Communications." We look forward to incorporating your valuable insights and advice into our next edition.
Additional Notes
- Our newsletter is tailored for easy reading in all formats, including an accessible online version.
- Your feedback is essential for us to continually improve.
- We uphold the highest standards of confidentiality and privacy.
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