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News for Arthritis Foundation Program Instructors in the Arthritis Foundation, Great West Region

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 Articles This Issue

Instructors in Action
Doris Lilly adds joy, humor and thorough planning to her Arthritis Foundation Exercise Programs – with great success. Find out how.

Quarterly Reports Due
Submit your reports by January 15, 2014. Download the forms. 

Programs for Better Living Undergo Policy and Procedure Revisions
Revisions to the Programs for Better Living simplify certain processes for instructors and facilities.  Find out about the changes.  

Upcoming Trainings
Give someone the opportunity to take control of their arthritis in 2014. Recertify as an Arthritis Foundation instructor or invite a friend or co-worker to become certified. See the list of upcoming trainings.

How to Appeal a Denied Medical Claim for Arthritis Care
Action steps to take if your insurer denies a claim for arthritis-related care or other health services. Find out more.

More Americans Limited by Arthritis Pain
Nearly one in ten people say that joint pain impacts daily activity.  Learn more.

Photos from the Field

The Many Forms of Arthritis
Learn more about the signs, symptoms and treatments for myositis.  

Get Connected 



Instructors in Action

Doris Lilly adds joy, humor and thorough planning to her Arthritis Foundation Exercise Programs – with great success.




Doris Lilly
Master Trainer for the Arthritis Foundation Exercise Program
Bend Senior Center - Bend, OR


How did you first get connected with the Arthritis Foundation?
In the mid-1990s I was volunteering at the Juniper Swim & Fitness Center in Bend, and met my partner in crime, Carolyn Creedican. I was asked to come to an Arthritis Foundation Aquatics training to get a feel for the class and I was hired right after that! Then in 2003, I took the instructor training for the Arthritis Foundation Exercise Program and decided I loved to do that too. Then I started teaching at the Bend Senior Center. I’ve been doing that for ten years now, and slowly building my class. I have about 35-40 regulars in my class now! I even have a 100 year-old woman who exercises with us.

quoteWhat other ways are you currently involved with the Arthritis Foundation?
For years now I have taken people from my class and walked the Jingle Bell Run/Walk in Bend. We always stopped at the end and ate lunch together. About eight years ago, I took the training to be a master trainer for the Arthritis Foundation Exercise Program. Carolyn and I have been teaching new instructors for about seven years now and I’ve traveled to other states. This past year I was nominated to be the Adult Grand Marshal for the Jingle Bell Run/Walk. I had a lot of fun in my sash and tiara and presiding over activities for the weekend.

What keeps you teaching with the Arthritis Foundation year after year?
I truly just get a lot of joy from teaching this class. I know I really am helping people. I hear so many wonderful things from my participants that make me want to stay. There was one participant who is about 95 who thanked me because in her words she told me she “could do this year what she could do last year,” meaning that she had maintained her strength and mobility. If my participants are brave enough to come and exercise with me every day then I can keep teaching them. If I can leave my participants laughing then I feel I have done something good.

What advice do you have for struggling instructors?
exercise instructorsKeep looking for new ways to do things! I spend a decent amount of time actually planning out the class. Remember there are around 100 exercises in the manual! You can use every single one of them. Even something as simple as making regulars sit in a different spot can make things a little exciting. When in doubt, go to the dollar store and buy bouncy balls and play a memory game with them!


Interviewer note from Cindy Bishop, Arthritis Foundation staff member - my favorite memory of Doris:
My very first time coordinating an instructor training was with Doris and Carolyn. As part of every Exercise training Doris has all the new instructors sit in their chairs in a circle and do round robins with different props. Her most famous prop is actually a plastic pickle that yodels. Each instructor holds the pickle and gives his or her best yodeling impression. It’s a really great icebreaker and I will never forget the moment I first laid eyes on that silly pickle!




Quarterly Reports Due January 15, 2014


Program reports are due by January 15, 2014. Click here to access the forms and our return contact information.




Programs for Better Living Undergo Policy and Procedure Revisions

Revisions to the Programs for Better Living simplify certain processes for instructors and facilities.



As the Arthritis Foundation continues to grow and enhance our physical activity programs, changes have been made to the policies and procedures. These changes will remove some barriers without changing the program components. The new policies and procedures will start January 1, 2014.

The changes are as follows:


Professional liability insurance may now be provided by a facility/employer or by the instructor/leader.

  • Instructors/leaders do not have to find or rely on a facility to sign a co-sponsorship agreement if the Instructors/leaders have their own professional liability insurance coverage with aggregate/single occurrence limit not less than one million dollars ($1,000,000.00) for personal injury or property damage.
  • Instructors/leaders can continue to use the liability insurance coverage provided by their employer’s or facility’s if a co-sponsorship agreement is signed.
  • The instructor/leader is responsible for ensuring the location or facility meets any applicable requirements, for collecting and maintaining forms, and for submitting the participant release and program information forms. The instructor is also responsible for ensuring a safe atmosphere for his/her class.


Instructors are certified upon completion of a training workshop. Recertification is every two years.

  • Instructors/Leaders are no longer required to teach a series of six classes prior to receiving their certification.
  • Instructors/Leaders will now be considered certified upon attendance of an in-person instructor training. AF Exercise instructors who do the on-line training or AF Tai Chi instructors who attend non-AF trainings will still need to fill out a certification application.
  • Recertification for AF Aquatics Program, AF Exercise Program and AF Tai Chi Program will now be every two years. The Arthritis Foundation will honor certifications given prior to these changes for three years.


Arthritis Foundation Participant Release Forms do not have to be used if a facility has its own release forms.

  • Instructors are still required to ensure that there is a completed release form on file for each participant and submit the form for new participants to the Foundation each quarter. However, if a facility requires individuals to complete a release form upon enrollment those forms can be used in place of the AF’s Participant Release Form. If the facility does not have its own release form the AF Participant Release Form should be used.


Page two of the Participant Release Form has been revised to include standard language for participants in all Arthritis Foundation programs and special events.


There is a new online Arthritis Foundation Exercise Program training.

  • We are excited to offer an online training through the Aerobics and Fitness Association of America (AFAA).  The program fee is $129 and includes: an interactive online training workshop; downloadable PDF instructor manual (you can buy a manual for an additional cost); and a one-year AFAA membership – a $68 value.
  • Online trainings are available in two versions. The “Live” version is like a webinar and will most likely be offered on a monthly basis. The National office is in the process of scheduling future trainings. The second version is an on-demand version that can be accessed 24/7/365. You can access both trainings at
  • The Foundation will continue to offer in-person Arthritis Foundation Exercise Program trainings.


If you have any questions about these changes please ask your Arthritis Foundation staff contact for clarification.




Upcoming Trainings


Give someone the opportunity to take control of arthritis in 2013. Recertify as an Arthritis Foundation Instructor or invite a friend or co-worker to become certified. Search the event list for upcoming trainings.



How to Appeal a Denied Medical Claim for Arthritis Care

Action steps to take if your insurer denies a claim for arthritis-related care or other health services.

Reprinted from

deniedEach insurance company is different, and not every claim may be covered. Here’s what to do if your insurer denies a claim for arthritis-related care or other health services.

File an Internal Appeal
Ask your insurance company to review its decision. You must do this within six months after learning your claim was denied.

To file an internal appeal:

  • Review the appeals process, which should be outlined in the rejection letter from your insurance company.
  • Fill out the appeal form(s) your insurance company provides.
  • Ask your doctor to write a letter or provide other background material to help your case.
  • Keep copies of all forms, as well as notes from phone conversations with your doctor and insurance company.
  • You can also ask the Consumer Assistance Program in your state to file an appeal for you.

Once the internal appeal review is finished, you should get a written decision in 30 to 60 days. If the claim involves a serious health issue, ask the insurance company to speed up the process.

Get an External Review
If your appeal is rejected, you can ask for an external review of your claim. That means an independent person outside of your insurance company will do the review.

To request an external review:

  • Submit a written request for external review form within 60 days of the date you received the insurance company’s decision.
  • Or, ask a doctor or other medical professional to request the review for you by filling out an Appointment of Representative form.

If external review is in your favor, the insurance company will have to pay the claim. However, the reviewer may stick with the insurance company’s original decision.

Find out more:
For general information about filing appeals, go to:

To find your state’s Consumer Assistance Program, visit:

To start the external review process, call: 877-549-8152 or visit:

To get help filing an internal appeal or external review, visit your state’s Department of Insurance:




More Americans Limited by Arthritis Pain

Nearly one in ten people say that joint pain impacts daily activity. 

crowdA government report from the Centers for Disease Control and Prevention (CDC) released recently found the number of adults with arthritis is rising by about one million people each year, and along with it, the debilitating impact of the disease. The report reaffirms previous predictions that cases of arthritis would rise rapidly with the aging of the population. However, the impact of arthritis on activity limitations is exceeding previous estimates, according to the Arthritis Foundation.

“The sharp rise in activity limitations is alarming,” says Arthritis Foundation President and CEO, Ann M. Palmer. “More people are hurting when they walk and climb the stairs, and they may be curbing activities they love due to severe pain and limited mobility caused by the disease. We must reverse this trend by investing more dollars in research to find a cure for arthritis and providing health intervention programs to help people be more active today.”

According to the CDC study published in the November 8 issue of Morbidity and Mortality Weekly Report, arthritis affects the daily activities of about 23 million adults, up from 21 million in 2009, and not far from the projection of 25 million that wasn’t expected until 2030.

The report also confirms the disease is common, impacting about 23 percent of the adult population. The 2013 report shows that the number of adults with doctor-diagnosed arthritis climbed from roughly 50 million to 53 million over the last three years. Arthritis also carries a heavy financial burden, costing the U.S. economy $128 billion annually.

Among the report’s findings from 2010-2012:

arthritis stats

“The number of U.S. adults with arthritis is increasing. This amounts to an average increase of approximately 2,400 individuals per day,” says Dr. Wayne H. Giles, Director of the Division of Population Health at the CDC. “Because arthritis occurs so often with other conditions like diabetes and heart disease, arthritis limitations may be interfering with the recommended management of those conditions, especially in regards to physical activity.”

The Arthritis Foundation is working to help address this ever-growing problem by advocating for policies and programs to help people get treatment and care, driving innovative research toward a cure, and providing information and programs to help people manage their disease. In addition, events such as the Arthritis Foundation Jingle Bell Run/Walk for Arthritis bring the community together each year to raise funds to fight and cure arthritis.

To learn more about the impact of arthritis and what you can do about it, visit




Photos from the Field


Tai Chi

Participants practiced Tai Chi at the Arthritis Foundation Tai Chi training held on December 7 & 8, 2013 in Oakland, California. Twenty five instructors were trained.







The Many Forms of Arthritis

Learn more about the signs, symptoms and treatments for myositis. 

Myositis is defined as the inflammation of muscles (“myo” means muscle and “itis” means inflammation). Myositis is a part of a group of disorders called inflammatory myopathies. These disorders are characterized by inflammation and weakness, mainly of the muscles closest to the trunk of the body (proximal muscles). These disorders include polymyositis, dermatomyositis and inclusion body myositis. Myositis may be associated with inflammation in other organs, including the joints, heart, lungs, intestines and skin. In dermatomyositis, a rash develops in addition to the muscle inflammation.

Each of the disorders associated with myositis have different effects.

Characteristics of polymyositis can include symmetric weakness of the large muscles closest to the trunk of the body. Shoulder and pelvic girdle muscles are most severely affected. The weakness may make it difficult to lift heavy objects, climb stairs, or lift your arm to comb hair or put on a coat. Polymyositis can cause weakness of the muscles required for breathing. It may also cause fibrosis (buildup of excessive scars tissue) of the lungs, which results in coughing and shortness of breath. People with myositis may experience fever, weight loss, general malaise and Raynaud’s phenomenon (an extreme sensitivity and discoloration to cold, especially in your fingers). Pain in the joints commonly occurs during periods when the disease is active, but the joints are not usually warm or swollen.

Dermatomyositis is an inflammatory muscle disease, like polymyositis; however, it has a somewhat severe onset and affects both children and adults. Clinical features of dermatomyositis include all those of polymyositis, plus a variety of skin manifestations.

Juvenile dermatomyositis differs from the adult form because of the coexistence of vasculitis (inflammation of blood vessels), calcium deposits and defective metabolism of fat. In juvenile dermatomyositis, the skin lesions and weakness almost always occur at the same time, but the severity and progression of each symptom varies from patient to patient.

Inclusion body myositis mainly affects older individuals. The symptoms begin and progress slowly. Symptoms often are present for five to six years before diagnosis. Swallowing difficulties are noted in more than 20 percent of patients. As muscle weakness becomes severe, it is accompanied by muscle wasting and diminished deep-tendon reflexes. Unlike polymyositis and dermatomyositis, the muscle weakness is often not as symmetric, and may be prominent in the smaller muscles of the forearms and calfs.

To diagnose myositis, your doctor will ask you a series of questions about your symptoms, perform a physical exam and order several laboratory tests. Treatments can include rest, physical therapy and medications such as corticosteroids or DMARDS.

Find out more:
Learn more about myositis in the disease center section of our website.




Get Connected


Find your local Arthritis Foundation office to get connected to programs and events.

Find out about all of our volunteer opportunities on our Volunteer Resource Page or fill out a volunteer application.

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