Tag Archives: health

Embracing the Discomfort – The Plan

Expand-yourself-Get-out-of-comfort-zone

The 5th anniversary of my 29th birthday is in a little over 3 weeks and I’ve been thinking about things that I’ve learned about myself over the years.  I’m nosy.  I have an extraordinary memory, which passes for intelligence about 95% of the time.  I will probably never be a morning person no matter how hard I try.  I can be very envious and insecure…and I have an absolutely incredible tolerance for pain.

imagesThat last part is going to sound like bragging when I explain it, but it’s really not.  When I know something is SUPPOSED to hurt, I let it hurt.  Case in point: I had horrible dry socket after my wisdom teeth were extracted because no one remembered to give me a syringe and the instructions to prevent dry socket.  So when I was in pain 2 and then 3 weeks later, I just thought, “Well I just had surgery.  It’s supposed to hurt.”  The oral surgeon was appalled at my final visit.  I’ve had the same thing happen to me in the ER on Christmas Eve with strep throat*, from the neurosurgeon who diagnosed those ruptured discs in my neck, and from a different neurosurgeon after the operation to remove those ruptured discs.  “How are you sitting here without writhing and crying?  Why aren’t you asking for more pain meds?  Why aren’t you taking the ones we gave you?” or something along those lines.  My answer is always the same:  “I’m sick, I’m injured, I just had surgery.  It’s SUPPOSED to hurt, right?!  Complaining doesn’t help.”  I just always assume that the amount of pain I’m in is the amount I’m supposed to be in and deal with it.  Evidently some of you are whiny little drug-seeking bitches, though.

That being said, while I do have an incredible tolerance for pain, I have ZERO tolerance for discomfort.  I hosted a bridal shower for my friend Lea many years ago, the weekend Pope John Paul II died (great memory, right?).  I was outside planting flowers in pots for several hours the day before the shower.  It was early April in Baton Rouge, sunny but not hot, and there was a lovely breeze.  It was a beautiful day.  For a week after, my lips feel like they were constantly covered in cellophane and it was all I could do to get out of bed.  I don’t think I talked about anything else for a week except which lip balms I liked and which I didn’t.  In the case of discomfort, complaining does help because it makes others around me miserable too and, seriously, why should I suffer alone?

Me in a room that's too stuffy.

Me in a room that’s too stuffy.

If the thermostat is too hot or cold, I’m dying.  Bug bites and paper cuts make me want to check myself into a mental ward for a sedative.  People have found me in my office before, rubbing myself on a door jamb trying to scratch my back like a cartoon bear.  I really would rather be stabbed in the gut than sleep in a room that doesn’t have a fan.  I’m the whiny little bitch in this scenario and I’m ok with that.

What does all this nonsense have to do with my plan?  Well…summer 2013 is going to be The Summer of Dominique’s Discomfort.  For starters, I’ve signed myself up for a 7:30 am Zumba class on campus.  This isn’t a fun class that I can drop anytime.  This is for credit and I will be assigned a grade.  I don’t need this class to graduate, but it only cost $60 more and for 2 months of Zumba, I might as well.  Did I mention the part about not being a morning person or liking to sweat?  What have I done?  Did I mention also that I’m a former smoker and since my knee surgery 14 years ago I have become about as limber as a rusty lawn chair?

ive-made-a-huge-mistakeAlso, I signed up for one of those Color Runs at the end of June and roped 2 friends into joining me.  It’s a 5K.  I haven’t started training AT ALL yet, and I haven’t run in…EVER.  My whole life I have been able to swim a mile before I could run one, so that’s gonna suck — and I paid money to do this.  Holy shit.i-exercised-once

Once I lose some weight, I want to start biking again.  For now balancing all this heft on my hoo-ha on a bike hurts my hiney more than is worth it.  That will be later in the summer.

I’m going off sugar.  I’ve done an Atkins-esque plan before.  No, it’s not high protein.  No, it’s not all bacon.  You basically eat your body weight in veggies.  Look it up.  I feel a lot better when I do that and I have a lot more energy but that first week is a bear.  None of you are going to want to give me even the slightest criticism on Facebook, Twitter, over the phone or in person or we might both end up on the news.  What is the opposite of the Twinkie defense?

Or you'll do what I do which is to watch all the good food go bad and order pizza.  And ice cream.

Or you’ll do what I do which is to watch all the good food go bad and order pizza. And ice cream.

I’m going to be in school (the Zumba plus another easy class) and working this summer.  At the same time I have plans to do a lot of HR and finance education to make myself more valuable at work.  That won’t be uncomfortable but will be a bit time-consuming.  My summer reading list is already at about 8 books and that doesn’t include anything for school yet.  I’m very lucky to have a cool boss who is grooming me for bigger things.  ”Learn More Stuff” is actually my number one summer assignment.

There is still the elephant in the room with Dad, and considering my birthday and Father’s Day always go hand-in-hand, at some point some awkwardness will have to be addressed there…I hope.  I’ve reached out.  We’ll see.

What has inspired all of this apart from this blog and all of you?  Two friends that I HATE.  Remember when I said I could be envious?  I really can.  And I don’t hate them in the way I hate Al-Qaeda or Gwyneth Paltrow.  I’m not angry at them.  I hate them in a way that you can only hate someone you really love.  The truth is that I adore them both but they have achieved so much while I have been stagnating that it just makes me sick with happiness, admiration and seething, undying jealousy.  They are AWESOME and I am NOT (yet).  They’ve been through the pain already and I have yet to begin.

Here they are together.  At once the banes of my existence and my reason for getting up in the morning.

Here they are together — at once the banes of my existence and my reason for getting up in the morning.

Look at the guns on this b...est friend of mine!

Look at the guns on this b…est friend of mine!

Julia** lives in Portland and is raising 2 wonderful boys with her husband.  I lived with her for a while in college and she was never ever fat, but she was not the lean machine she is today!  She’s taken up fitness as her life’s purpose pretty much and she looks amazing.  Even more than the changes to her appearance, though, she has achieved so much.  She has run a couple full marathons, I think.  I know at least one was for Team In Training, so she did a good deed there.  She did an Olympic-distance Ironman, I think.  She routinely does half-marathons and smaller triathlons. Some of that may be wrong, I have no idea.  All I know is she has a shitload of medals and I have an assload of cellulite.  She is in incredible shape and really enjoys what she’s doing.  I’m jealous.

This one used to shun photos like the plague and now he's taking them all the time.  And always smiling!  It's like he knows something that I should be learning.  Hmmm.

This one used to shun photos like the plague and now he’s taking them all the time. And always smiling! It’s like he knows something that I should be learning. Hmmm.

My friend John** lives in Houston and he has recently lost something crazy like…200 pounds.  I don’t know the exact number but it’s a lot.  He was depressed and fat (I’m familiar) and something just clicked for him one day.  He went to a medically-supervised weight loss program, began working out, and now he’s lost all this weight, toned up, and has also been bitten with the running and triathlon bug.  His confidence has gone through the roof.  He’s a fitness evangelist now that makes Jimmy Swaggart look like some stuttering wallflower in comparison.  He is so much healthier, so much more vibrant and a real inspiration.  Again, I’m jealous.

And I know I could do something about it and change my life but it’s just so much easier to sleep in, to watch Netflix instead of studying, to order pizza instead of cooking for myself, and make “easy” choices instead of difficult ones.  BUT…since hopping out of my comfort zone accidentally worked so well earlier this year, that’s what I’ve got to do now.  I’m slowly learning that lesson.  The fact is, this summer is probably going to suck.  Maybe even more than the summer of mental illness or neck brace.  It’s going to be sweaty and uncomfortable and painful but hopefully I’ll be better for it at the end…waist a little smaller and brain a little bigger, or more wrinkly or something.

Growth does not happen in the comfort zone.  I have to remember that.

Growth does not happen in the comfort zone. I have to remember that.

My official motto:  Embrace the Discomfort.  It’s Definitely Going to Suck, But It Probably Won’t Kill Me.

Will keep you posted!  Any words of encouragement would be wonderful, but I’m warning you guys…June 1 and all the carbs are gone.  At that point, any criticism will be viewed as an act of war.

Hope everyone had a great long weekend! – HRGF

*Don’t ever go to the ER on Xmas eve.  The morgue will feel sorry for the ER staff and send up a ham.  Apart from the gross irony of getting meat from the morgue, the ER staff will be overjoyed at ham and will forget about you for 2 hours.

**Names and locations changed to protect friends I hate.  With love.  But then I put up their pics so whatever.

Change Doesn’t Take Time – It Takes Change

My life has been through some great changes recently and I think it’s got me hooked on the whole concept of change now.  I’m jonesing for more change.

A Brief Recap

joanIn May 2011, I was in pain.  I had 2 ruptured discs in my neck and ended up having major surgery.  That summer kinda sucked.

In May 2012, I was in a different kind of pain.  I was severely depressed and having panic attacks and afraid to tell anyone about it.  My family, friends and coworkers knew I’d suffered depression for years but it had gotten markedly worse in April/May and I didn’t want anyone to know that part.  I thought they’d be worried that I’d do something awful and irreparable, even though nothing like that EVER crossed my mind.  I was in pain though and suffered largely in silence.  Last summer definitely could’ve been better.

slothNow it’s May 2013 and life is AMAZING.  I’ve made great progress in school and I can see the finish line, somewhere.  I have a new-ish and fantastic job that is a PERFECT fit for me.  I love the people I work with, I get to wear sweatpants/no pants about 80% of the time, and still be bossy and a perfectionist.  My family and friends are doing well.  My $$$ is doing well.  My depression is under control.  I have quit smoking for a while now.  Life is good.  Change is good.

What Happened?

welcomeDid it take a year for all this change to happen?  No, it’s taken 4 months and 13 days.  How do I know that?  Because I started this blog on January 4th.  Unemployed at the time, I wanted something to occupy my time and learning more about HR seemed a good start since that was my field and I was basically faking it…or that’s how I felt.  Since then, this blog has been received warmly among people who clearly AREN’T faking it.  I’ve been invited to do guest posts for other blogs (will change link to my post once it’s published) and awesome people have assisted with mine.  I’ve met lots of new people, become more involved in my local HR and business scene, and “met” thousands more on Facebook and Twitter.  HR Rock Stars.  I have met some in real life, others I know I will one day, and some have become great confidantes, advisers and friends.  Remember when I said HR was a big ol’ clique?  Still true.  But when I said they were friendly and welcoming, I had no idea what an understatement that was.

The Change Process

How did I accomplish this?  Did it happen naturally and without any effort from me?  Absolutely not. I butted in.  I interjected in Twitter conversations I found interesting, I commented on blogs, I asked total strangers for advice and opinions, and totally crashed that party.  Was it always comfy for me?  No.  I am still intimidated by these rock stars since I have no degree (yet) and I’m only informally studying HR.  Why should the talent acquisition chief from Expedia ever talk to me?  Guess what?  He did.  He does.  You’re not reading this, but just in case…hi Jer!  (Honestly, when I reached out to him on LinkedIn, I thought he was someone else, but whatever.  He’s cool.  There’s a pic of him wearing a cape on my FB timeline, so he’s clearly odd, which is EXACTLY the type of people I like to be on my FB.) There were a few moments of awkwardness with some people but for the most part, it wasn’t too bad.  Stepping out of my comfort zone, not into a neutral gray area of I-don’t-give-a-damn-ness, but into active discomfort has achieved great results.

Now What?

Is my life perfect right now?  No.  I am still woefully overweight and out of shape…not beating myself up over this, though, cause I did quit smoking, so yea.  I want to add more value to my company, so I’m trying to learn accounting and more HR this summer.  I’m not quite done with school yet so there’s still some work to be done there.  My dad and I are talking, but there’s an elephant in the room we haven’t addressed.  I’m not going to link to it, but regular readers will know what that is.  I haven’t spent enough time with my local friends or talking to my distant ones (my real, non-HR people).  My apartment is a disaster.  I need to floss more.  You know, the usual.  It’s time for some more change.

People say change takes time.  No, it doesn’t.  It takes change.  Real, actionable, quantifiable CHANGE.  I look at my life right now and where I was 4 months and 13 days ago and it could not be more different.  So that’s my new project — the next three and a half-ish months.

project

I have a few weeks now before summer school starts.  Then 2 months of school and another few weeks of freedom.  On Labor Day, I want to look back and say, “I remember that day…sitting on my boss’s sofa at the ass crack of dawn because she accidentally scheduled herself a flight so early not even Superman would put up with that BS, blogging while her daughter slept, about to get her ready for school — and look how much my life has improved since then.”  Rolling over and watching Buffy till I fall asleep right now, though tempting and guaranteed to be awesome, is not going to bring about the change I’m seeking. That’s the old path; I already know where that leads.  I’m on a new path now.

I didn’t have a plan 4 months and 13 days ago and I still accomplished a lot…with some luck, some great friends/family, and some innovative interrupting, if you will, on my part.  This time I do have a plan and I am looking forward to BIG RESULTS and BIG ACCOUNTABILITY from you guys!  So what’s the plan?  What are my goals between now and Labor Day – and how do I intend to achieve them?  Ahh.  Check back on Tuesday and all will be revealed.

tuesday

 

Have a great weekend everyone!!  I’m starting my plan immediately!! – HRGF

ERISA Lesson (Pt 1) with Guest Jeremy Bordelon – Teaching Tuesday

ERISA Lesson

The following is an email exchange between my attorney buddy, Jeremy Bordelon, and myself.  He tells me we’ve barely scratched the surface of ERISA here.  Maybe he’ll grace me with a Part 2 sometime in the next few weeks.  My words are in bold.  Everything else is Jeremy.

I have done a lot of benefits administration in my day, but I don’t know much about benefits LAW.  I am SUPER weak on this topic. I could barely come up with any questions, so add anything you want!

Thank you!

ERISA-Congress

Employee Retirement Income Security Act – Became Law in 1974 – Has to do with protecting employee pensions and tax effects of other benefits plans.

Well, it’s that, but it’s more than that.  In the beginning of ERISA, when it was thought of as a “good thing” for employees, employers and benefits administrators were looking for any exception they could come up with to get out from under ERISA.  The courts responded by ruling that nearly everything that had anything to do with an employee benefit was preempted by ERISA.  So now nearly every benefit an employee gets from any private employer is governed by ERISA.  Health insurance, life insurance, disability insurance, and of course pensions.  Now, many employees wish they could get out from under the “protections” of ERISA, but employees are stuck with it.

pensions eggs

Since employee pensions are largely becoming extinct, what does this have to do with other retirement options?

ERISA has a lot of rules regulating what happens when a pension plan shuts down.  As the concept of a traditional “defined benefit plan” dies out, ERISA tells everyone how to wrap things up properly.  As 401(k)s and other types of “defined contribution” plans have become more prevalent, ERISA provides guidance for how those need to be run as well.

Since ERISA is often substituted for “all laws regarding benefits” it includes amendments that created COBRA and HIPAA.  I will probably address those in the blog at a later time.  What other significant impacts does ERISA have on health plans?

The main impact that ERISA has on health plans is the limitation on remedies for the participants.  As the guy who helps people get their benefits when they’ve been denied, it’s certainly the main impact on my clients!  When I represent people who have had a benefit claim denied, I have to explain to them what ERISA means for them, and it’s mostly bad news.  That list of bad news includes:

1)  It may take a year or more to exhaust all your appeals with the administrator, and you must complete that process before being allowed to go to court to pursue your benefits.

2)  If your appeals are exhausted and you do have to file suit to pursue your benefits, you will not have the right to a jury trial.

3)  You will not be able to seek any extra damages for a “bad faith” denial of your claim.

4)  No matter what the administrator said or did, no matter how well-supported your claim was, you cannot seek any extra damages whatsoever.  It does not matter if you lose your leg because a health claim was denied.  It does not matter if you lose your house because your disability benefits claim was denied.  No matter what, the administrator will not have to pay more than they should have paid on your claim in the first place (aside from paying, perhaps, part of your attorney’s fees, and maybe some interest on past-due benefits).

5)  In most cases, the administrator gets the benefit of the doubt, and a denial of your claim will only be overturned if it is ruled to be “arbitrary and capricious.”  This means that if the administrator has any evidence at all supporting its decision, you will lose.  A recent survey of benefits litigation found that claimants get benefits denials overturned in court only about 30% of the time.

no money

Usually, the only good thing I have to tell people when I explain what ERISA means to them is this – it’s cheap to litigate in this area.  This, too, bears an element of bad news, though.  The main reason that it’s cheap to litigate in this area is that there isn’t much discovery allowed.  As an attorney, I usually can’t get the court’s permission to do things like take depositions, serve discovery requests, or introduce extra medical evidence in support of my client’s claim.  Bad for the case, good for the expense bill my client has to pay at the end.

I’ve heard people saying things like “We have to make sure this passes the ERISA test” with regards to discrimination.  Is this the part about highly compensated employees setting aside and receiving a proportional amount of salary/match to other employees?  Or are they referring to some other discrimination test?

That could be what they’re referring to.  ERISA does have rules about equality between highly compensated employees and everyone else.  On a day-to-day basis, that would probably be what you heard people talking about.  There is another anti-discrimination provision in ERISA, though.  It states that employers can’t take adverse actions against employees for attempting to exercise their rights under an ERISA pension or welfare benefits plan.  The same section of ERISA provides for whistleblower protections, too.

What else should I know to have a reasonable understanding about this?

Well, on the employer side, there are a few things HR folks need to know.  In addition to making sure people are enrolled properly, making sure premiums are paid properly, and making sure claims are forwarded to third-party administrators properly, the HR pro’s biggest and most important job is providing information.  For failure to provide plan documents on request, the plan administrator (usually the employer) could be subjected to penalties of up to $110 per day.  These penalties do not go against any third-party administrators, only the “plan administrator” itself.  If the Department of Labor is asking for information, the penalty for a late response could be up to $1,100 per day.

img_fines pay fines

HR pros can also run into problems just answering (or not answering) employee questions.  Plan fiduciaries (employers as plan administrators, insurers as claims administrators) have an obligation to convey complete and accurate information material to the participant’s (or beneficiary’s) circumstances.  This includes answering questions the participant didn’t think to ask.  For failure to do so, participants can’t currently get money damages in court, but that may change.  (DOL guidance suggests money damages should be available, but currently the courts aren’t following that guidance).  “Equitable remedies” (non-money damages) available for these errors can be substantial, though, including a complete re-write of the Plan to comply with the faulty information given.

For example, consider the case of Krohn v. Huron Memorial Hospital.  Mrs. Krohn was a nurse who worked at the hospital.  She was in a coma after a car accident.  When her husband asks about short term and long term disability benefits, he’s told by HR that the Krohns would be better to stick with the benefits offered by their auto insurer than to file applications for the employee disability benefits plans.  The HR person was under the partially mistaken understanding that 1) auto insurance usually pays more than STD, and 2) that you can’t get both at once.  Based on this advice, Mrs. Krohn did not apply for STD or LTD.  What she should have done was apply for LTD.  Even if she couldn’t receive both benefits at the same time, she would at least have a live claim.  Instead, Mrs. Krohn returns to hospital HR four years later, when her auto insurance benefits are exhausted, asking if she can now file a claim for LTD benefits.  The third-party carrier refuses to consider such a late claim.  Mrs. Krohn has no way under ERISA to force them to do so (she’s long since missed the deadline to apply under the strict terms of the plan).  Instead, she sues the hospital for providing inaccurate or incomplete info about the plan.

The court held that the hospital had a duty to make sure that the Krohns understood everything they needed to know about her benefits, even if the Krohns didn’t know the right questions to ask.  The “duty to inform is a constant thread in the relationship between beneficiary and trustee; it entails not only a negative duty not to misinform, but also an affirmative duty to inform when the trustee knows that silence might be harmful.”  Because of the bad advice Mrs. Krohn got from HR, the hospital wound up having to pay 20+ years of LTD benefits itself, because the third-party insurer was covered by the fact that the claim was not filed on time.

tina

I expect that cases like Krohn would probably keep HR people awake at night.  I mean, to a certain extent, the courts expect you to be mind-readers.  You’re supposed to know what information plan participants need, even when they don’t really know themselves, or else your company could be on the hook for benefits you thought were insured by a third party.  Don’t get me wrong – for every case like Mrs. Krohn’s, there are probably a dozen others where the employee gets nothing.  But I don’t think any responsible HR professional wants that to happen, either.  Talk to your employees and do your best to keep them informed about the terms of their benefit plans.  Hopefully issues like these can be avoided entirely.

stressed_woman

*GULP*  This is the part of HR that makes me get overwhelmed and want a nap.  I just like helping people.  Ugh.  This whole employment law bit is both incredibly boring and scary.  I just know I’m gonna get arrested for something one day.  :)   More study needed!!

http://www.dol.gov/ebsa/faqs/faq_compliance_pension.html

http://www.dol.gov/dol/topic/retirement/erisa.htm

http://newsroom.infinisource.com/post/2012/08/16/Who-Does-What-on-Your-ERISA-Plan.aspx

Jeremy Bordelon

Jeremy Bordelon has worked at the Chattanooga, Tennessee law firm of Eric Buchanan & Associates (http://www.buchanandisability.com/) since 2004.  He’s worked his way up from paralegal to junior partner (so far).  While working for the firm, Jeremy earned his Bachelor’s degree in Legal Assistant Studies from the University of Tennessee at Chattanooga.  He then earned his law degree from the University of Tennessee College of Law in 2009, magna cum laude.  Jeremy is admitted to practice before all State and Federal courts in Tennessee, as well as the United States Courts of Appeals for the 6th and 11th Circuits.  He has successfully handled hundreds of social security disability, private disability insurance and ERISA long-term disability benefits cases.  Prior to law school, Jeremy served eight years in the U.S. Navy as an enlisted Cryptologic Technician, achieving the rank of Petty Officer First Class.

In his spare time, he enjoys road cycling, woodworking, and sailing with his lovely wife.  He likes his steaks medium rare, and he’s never seen LOST or The Wire!  His fave character on The West Wing, though, is Josh Lyman so that’s an acceptable substitution.