Plain Language Matters

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VA Simplifies Claims Processing Regs to Better-Help Disabled Veterans

Guest Blog by William F. Russo, Office of Regulation Policy & Management, in the VA Office of the General Counsel

Shortly after Secretary of Veterans Affairs Anthony J. Principi took office in 2001, he appointed a VA Claims Processing Task Force to find ways to reduce the veterans’ disability claims backlog. 

The Task Force reported that VA regulations “are in dire need of updating and reorganizing to allow easier access to information that is vital in providing a timely, correct decision on a veteran’s claim.”  They urged the VA to “First, rewrite and organize the [compensation and pension] Regulations in a logical and coherent manner . . .” Secretary Principi endorsed that recommendation and launched the effort.

The largest and most comprehensive such project ever attempted by a federal agency, the “VA Compensation and Pension Regulation Rewrite Project,” has been underway since 2002.  VA’s goal has stayed the same all along: produce regulations that users can find, read, understand, and apply. 

VA benefits experts have reorganized regulations in a logical way, writing in plainer language and cutting out obsolete rules, such as those for Spanish-American War veterans.  They incorporated years of statutes, court holdings, and VA policy changes, so our staff can find all the claims processing rules in one place. Dozens of staff from its Veterans Benefits Administration, Board of Veterans’ Appeals, and Office of the General Counsel have pitched in.  So have talented law clerks. The public has also helped — sending VA hundreds of improvement suggestions.  This includes extensive comments by Veterans Service Organizations, who represent disabled veterans in their VA claims.

In response to public comments, VA revised and combined the regulations into one comprehensive rulemaking, published in the Federal Register on November 27, 2013.  Due to the document’s size, VA is providing 120 days for more public comments, twice the usual 60 days. 

VA will then start the next Project phase: drafting the final rule while keeping the regulations up to date — until the Secretary determines the best way for VA adjudication staff to transition to the new regulations.  While this may be challenging, VA’s dedicated employees can do it.

VA claims processing and appeals resolution up through the courts, are rules-based tasks. Better-organized and more clearly-stated regulations should help VA staff decide claims more quickly and accurately, as the 2001 Task Force aimed to do. 

President Obama embraced the goal of improving federal regulations in 2011 in his Executive Order 13563, “Improving Regulation and Regulatory Review.”  It requires federal agencies to make regulations “accessible, consistent, written in plain language, and easy to understand.”  It also requires “retrospective analysis of rules that may be outmoded, ineffective, insufficient, or excessively burdensome, and to modify, streamline, expand, or repeal them. . .” 

The VA Compensation and Pension Regulation Rewrite Project is the cornerstone of VA’s compliance with this Executive Order.

VA will continue striving to improve its regulations, to serve the President’s federal regulations improvement goal – and to serve the veterans, whose claims have surged in the past decade.

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Analysis: The High Cost of Gobbledygook

In an op ed originally published in Government Executive, Congressman Bruce Braley, the author of the Plain Writing Act of 2010, writes about the problems and costs of confusing government language, and about the role of the Center’s report card in addressing the issue.  Click here for full article

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Plain Language Report Card

Reposted from www.healthwise.org

Karen Baker, MHS, Senior Vice President, 11/25/2013

Plain language has been making headlines—in the world beyond health care!

Last week was report card time for federal agencies. The Center for Plain Language, a nonprofit volunteer organization based in Washington, D.C., graded 20 agencies and departments for compliance with the Plain Writing Act. President Obama signed the act into law in 2010, to little fanfare. It requires that government agencies use plain language in communicating with the public so citizens can understand forms and documents. (Did you know there was such a law?)

But even though there is no penalty for failure to comply with the law, the report card has gotten its share of media attention. That’s a good thing for those of us who believe that clear communication is vital to our ability to be engaged citizens—or patients. (In the spirit of full disclosure, I want to say that I serve on the board of the Center for Plain Language.)

As a former journalist, I am gratified to see news agencies doing their job as watchdogs. The Washington Post, NPR, Time, Federal News Radio, and Reuters are among the media outlets that have reported on the good, the bad, and the ugly since the Center released the report card last week. The report card includes two grades, one for how well the agency follows the letter of the law by meeting its requirements, and the other for how well the agency follows the spirit of the law by writing clearly. To sum it up, too many government agencies are not thinking about their readers.

First, some of the shining stars: The Social Security Administration earned two A’s. The Department of Agriculture scored well, too, with an A and a B. Among those who should face detention are the Treasury Department, which earned an F and a D, and Housing and Urban Development, which earned the same low scores.

If you wonder why this matters, just think about how often tax forms or mortgage papers or letters from a federal department or government rules have left you scratching your head. That confusion may only cause anxiety. Or, it may result in costly mistakes and more work for individuals and businesses that have to interpret federal rules and regulations. Clear communication is just as important in a democracy as it is in health care.

You can read the full report card here:
http://centerforplainlanguage.org/resources/plain-writing-laws/plain-language-report-card/

Representative Bruce Braley of Iowa, who wrote the act that is now the law of the land, isn’t satisfied. “Until these grades are all A-plus, we’re going to keep holding bureaucrats’ feet to the fire,” he told Reuters. He also has introduced a new bill (HR 1557) that would require the full text of regulations to be in plain language. If you agree that citizens should be able to understand federal regulations, ask your representatives in Washington to support the Plain Regulations Act of 2013.

You’ll find more information on both acts here:
http://centerforplainlanguage.org/

Clear communication. It’s our right.

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PLAIN 2013: From Vancouver, the Future Looks Clear

Heading back from the biennial conference of the Plain Language Association International (which was absolutely fantastic, by the way), I found my thoughts coming back to one presentation more than any other: Neil James’s look ahead at what the next 5 years may hold for plain language.
 
James’s thesis is that a host of different “communication enhancement” disciplines will converge. His list includes plain language, information design, information architecture, usability, and technical communication. There are also adjacent fields with which there is significant overlap, such as low literacy communication, controlled language, editing services, human factors, and marketing.
 
The logical response to this convergence, says James, is for all of us within the core set of disciplines to form a single, organized, more professional field under the banner of a single, appropriate, effective name. 
 
He’s right on every score.
 
A lot of people are confused by the different labels used by different practitioners, no one more than the practitioners themselves. That shouldn’t be surprising. Just within the one discipline of “plain language” there are many differences in how practitioners view the process, the focus, and the result — in some cases, even the basic purpose and philosophy.
 
The convergence only compounds this problem, because in addition to competing versions of the story within each discipline, we’ve now got competing disciplines. We can hardly expect our clients and employers to keep all this straight if we ourselves aren’t entirely clear on it. 
 
Actively working on a process of uniting and defining these disciplines, rather than just letting it happen, greatly increases the chances that the resulting field will be coherent, cohesive, and professional. It won’t be easy to do. But it won’t be any more painful than what will happen if we just let things continue on their merry way. And we’ll have a lot more to show for it — if only the fact that a bunch of communications professionals can actually solve their own communications problems.
 
As for what to call this new field, James sees “clear communications” as the clear choice from among the terms that are currently in use. Again, I’d agree, if that’s the pool we’re limited to. But I think it’s worth looking for, maybe even coining, a new term. 
 
That would give us the chance to find a name that suggests not just an absence of obstacles but an active attention to reader or user motivations. Most importantly, we might be able to find a name that suggests that what we do is, in many cases, a new and separate function — something akin to a curatorial function that involves coordinating all the applicable communications skills as well as the concerns of all stakeholders, internal and external.
 
I have no idea what that term would be. But we’ve got a few years to think about it.
 
Kudos to Cheryl Stephens, Kate Harrison Whiteside, and the rest of the Vancouver conference team. You guys did a great job! And you gave us all a lot to think about.
 
Josiah Fisk
More Carrot

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Ever get lost in an official or legal document?

In his newest column in the Legal Writing Editor (legalwritingeditor.com) Professor Joseph Kimble asks if there are any writers out there who think that the “mere style” of official and legal documents doesn’t matter much to readers. Are there any writers who think that attitudes toward style are all subjective and that no hard evidence supports the effectiveness of one style versus another? Professor Kimble’s message to those writers: you might want to think again. And read his column at legalwritingeditor.com.

Kimble calls his column “You Think Anybody Likes Legalese.” In it, he notes the 50 studies he collected, summarized, and cited in his book Writing for Dollars, Writing to Please. No less than 18 of those studies involved legal documents, and the documents were of all kinds. So were the readers: they included judges, lawyers, administrators, clients, and other members of the public. Kimble says that the evidence from the studies is unmistakable and compelling. His words:

Do you think anybody likes legalese? No. Nobody. Or I should say no body — not judges or lawyers or the public at large. All those groups strongly prefer plain language and find it more effective and persuasive. Besides that, they understand it better and faster, perform more accurately when they have to deal with it, and are more likely to read it in the first place.

Kimble has one more message, for anyone who needs to make the case for plain language with a colleague, supervisor, or high-level decision-maker: get Writing for Dollars, Writing to Please. The evidence Kimble summarizes — of the time and money that using plain language can save, and the many ways it improves the performance of readers — should convince even the most hardened skeptic.

Don Byrne
donbyrne.com

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There’s No Ease in Legalese

Matthew Salzwedel offers some great tips and persuasive advocacy in his online column, most recently Simple Legal Writing Isn’t Baby-Talk.
 
One answer to Matthew’s question, Can Legalese Tank Business Deals?, came from management consultant, Lyn Boxall. Read her full response at the end of
Matthew’s column.
 
In Asia, Boxall says, US-style legal documents can mar good business relationships before they start.
 
Potential clients and partners interpret the arrival of many, many pages of dense legalese as a sign of lack of trust.
 
Everybody loses!
 
She tells about putting a car lease into plain English for a finance company.
 
At first, the company was alarmed: potential clients were reading before signing — and asking questions.
But eventually the company had fewer customer disputes.
 
Because customers did read before they signed, they complained less often later; or,
if they read them later, they saw clearly-stated positions they couldn’t dispute.
Everybody wins!
 

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Hawkeye Pierce Pierces Barriers
Between Scientists and the Rest of Us

Earlier this year, CBS Sunday Morning interviewed actor and professor Alan Alda

about his efforts to help science students learn to speak to people in language they can understand.
 
After he hosted “Scientific American Frontiers” on PBS, he heard from policy makers, including Congressmembers, who keeping saying that they can’t
understand the scientists who come to talk to them.
 
“Why would you give money to somebody whose work you don’t understand?” Alda asked.
 
And he illustrates the value of plain language from doctors.
 
“Boy, did it ever! I was on a mountaintop in Chile, interviewing astronomers for the science program,” he recalled. “And within a few minutes I was in the worst pain in my life ’cause I had a strangled intestine. And about a yard of it was dead. I could’ve died within a couple of hours.
 
“But there was this wonderful doctor that they brought me to who said, in the clearest possible way, ‘Something’s gone wrong with your intestine and we have to cut out the bad part and sew the two good ends together.’ I said, ‘That’s great. Do it,’ you know? So there are times when you least expect it where good communication can come in handy.”
 

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New Resource: We ❤ Health Literacy

Our friends at CommunicateHealth just announced the launch of We ❤ Health Literacy, a new weekly email full of health literacy-related tips and tricks.

Their goal is to spread the word about health literacy and get people excited about making health information accessible. The posts will range from getting around tricky jargon terms to enhancing text with visuals and musings on plain language, design, usability, typography, and much more. Basically, if it’s related to health literacy, it’s fair game.

Check out their first post about the importance of writing with a conversational tone. If you like what you read, sign up to get post sent directly to your inbox.

If you have any ideas for posts, don’t be shy. Send an email to WeHeartHealthLiteracy@communicatehealth.com.

 

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Join a host of Plain Language Experts at the
20th Anniversary of PLAIN

Join a group of inspiring presenters and committed plain language advocates by attending the PLAIN2013 conference in Vancouver, October 10-13. 

http://www.plain2013.org/

Plain Language Association InterNational (PLAIN) is the leading international organization devoted to plain-language and information design. We are celebrating 20 years of advocacy around the world. 

Our speaker list includes presenters from Spain, Portugal, Brazil, Mexico, Australia, New Zealand, Belgium, Sweden, Norway, Britain, Canada, and the U.S. 

http://www.plain2013.org/plenary-speakers.html

Consider becoming a sponsor. What a great way to advertise your business! 

http://www.plain2013.org/sponsorship.html

Register and then stay through Sunday, the 13th and celebrate International
Plain Language Day.

http://www.plain2013.org/register.html

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Center for Plain Language honors March of Dimes with the Grand ClearMark Award; Charles Schwab captures the Grand WonderMark Award

Washington, DC – A March of Dimes brochure that effectively reaches its target audience with clear, concise writing and excellent graphics was honored with the Center for Plain Language’s Grand ClearMark Award as the best example of clear, concise communicationACharles Schwab magazine ad captured the overall WonderMark Award for the most confusing and complex language. The awards were presented at the Center for Plain Language’s fourth annual national ClearMark Awards, April 16, 2013, at the National Press Club in Washington, D.C.

The March of Dimes brochure, entitled Thinking About Your Family Health History, captured the Grand ClearMark Award (best in show). The judges said the brochure is written and designed with its target audience, parents-to-be, in mind. The brochure is an excellent example of plain language with easy to understand medical terms, and a clear, concise, and appropriate writing style designed to appeal to the target audience. The brochure uses colors, font, white space, and graphics effectively to add to its clarity.

“The March of Dimes brochure engages its target audiences with strong visual appeal and clear, concise writing,” said Annetta L. Cheek, PhD, Chair, Board of Directors, Center for Plain Language. “The medical terms are explained, it’s easy to use and offers moms-to-be clear and actionable information. Overall, it is a great example of plain language.”

The Grand WonderMark Award recipient was a Charles Schwab magazine ad. The judges said the ad was contradictory, hard to read and decipher, intimidating, and almost 90 percent of the language was legalese. One judge said, “Once again, a financial institution that expects me to trust them with my money [but] makes it impossible for me to know what they are going to do with my money. My mattress is looking better and better all the time.”

In addition to these two top awards, the ClearMark Awards name a top honoree as well as ClearMarks of Distinction (a plain language role model) and ClearMarks of Merit (a good effort toward plain language) in several different categories. Here are the additional award recipients:

Original or New Document, Nonprofit

WINNER: March of Dimes, White Plains, NY. Thinking About Your Family Health History. This brochure captured the Grand ClearMark Award and is described above.

  • ClearMark of Distinction: Mississippi Valley Conservancy, LaCrosse, WI. 15th Anniversary Magazine.
  • ClearMark of Merit: American Academy of Pediatrics and Centene Corporation/ Language Solutions Inc., Elk Grove Village, IL.

Original or New Documents—Public Sector

WINNER: U.S. Energy Administration Information, D.C. 2012 Writing Style Guide.  The judges said the document effectively uses plain language to teach plain language writing. The tone strikes the perfect chord of one professional talking to another. The writing is clear and the style guide uses headers, subheads, and boxes well. The words “correct” and “incorrect” make it easy to absorb the information. One judge said the style guide is “welcoming” and appropriate for the intended audience.

  • ClearMark of Distinction: Animal and Plant Health Inspection Service, U.S. Department of Agriculture, D.C. “Hungry Pests” Outreach Materials.
  • ClearMark of Merit: Substance Abuse and Mental Health Services Administration/JBS International, Inc., D.C. Treatment Improvement Protocol 54: Managing Chronic Pain in Adults With or In Recovery From Substance Use Disorders.

Original or New Documents—Private Sector

WINNER: Sun Life Financial, Toronto, Canada. Voluntary Benefits Broker Toolkit lead brochure.  The judges said this is a professional, polished sales piece that has the right tone and messaging and is consistent with the firm’s corporate identity. It uses charts, lists, bullets and photos well and features clear, concise writing appropriate for the audience. The judges said the brochure has a pleasant layout with a good structure and use of white space. The judges also felt that the brochure strikes a compassionate and empathetic tone for the sales team using it.

  • ClearMark of Distinction: Assurant Health, New York City. Access Product Sheet
  • ClearMark of Distinction: United Healthcare/Periscope, Minnetonka. Scarlet Says Good-Bye
  • ClearMark of Distinction: United Healthcare/Catchfire, Minnetonka. National Medicare Education Week
  • ClearMark of Distinction: United Healthcare/Periscope, Minnetonka. “Hello” campaign
  • ClearMark of Merit: Health Dialog, Boston. Help for Anxiety, Treatments that Work

Original or New Documents—Legal

WINNER: U.S. Fish and Wildlife Service, Wildlife and Sport Fish Restoration, Smyma, DE. Boating Infrastructure Grant Program, proposed rule. This rule is written simply and clearly. It avoids legal jargon by using familiar nouns and active verbs. The rule embodies many of the plain language elements including a good use of pronouns, tables and vertical listings in the text. The topic and audience are well defined and the question and answer format coupled with a solid use of plain language achieves the right tone. The proposed rule is easy to follow and explains how the new rule differs from the existing one. This rule is a model for how government agencies should write rules.

  • ClearMark of Distinction: Cooper & Kowalski, LPA, Toledo, OH. Sample Arbitration Clause.

Revised (before and after) — Private Sector

  • ClearMark of Merit: Assurant Health, New York City. Access Welcome Letter

Revised (before and after) — Nonprofit

WINNERCrime Prevention, Ottawa, Canada. Why community-based crime prevention works: case studies of three Ottawa communities. Overall, this document is a tremendous improvement over the previous version. This is a very good rewrite of a document that wasn’t working and now the revised version meets its purpose. The information sounds credible and the case studies make the findings accessible and relevant. Given the purpose of the report, the information is well organized and visually engaging with effective document design that includes the excellent use of headers, quotations and other markers to guide readers through the document.

  • ClearMark of Distinction: Sutter Center for Integrated Care, Sacramento, CA. COPD Spotlight Form.

Revised (before and after) — Public Sector

WINNER: Hennepin County, MN. Visiting the Hennepin County Home School. The purpose of the document is stated in the title and heading so that the intended audience is immediately clear. The writing is understandable and the information is kept to a minimum, informing visitors of just what they need to know. The tone is straightforward and to the point–but not as patronizing or threatening as in the first document. The main improvement with the new version is its simplification, but the improved structure and organization is also notable. The content is well laid out with plenty of white space and appropriate type. In this new version, the information is organized under distinct headings, and the shift from narrative to bulleted text is helpful. This document integrates all the elements of plain language to achieve its purpose.   

  • ClearMark of Distinction: National Asthma Education and Prevention Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Asthma and Physical Activity in the School: Making a Difference.
  • ClearMark of Distinction: Internal Revenue Service, D.C. CP 2000: Request Verification for Unreported Income, Payments or Credits.
  • ClearMark of Merit: Centers for Disease Control and Prevention, National Center for Environmental Health, National Asthma Control Program/Communicatehealth, Inc., Atlanta, GA. Asthma’s Impact on the Nation–Infographic.

Web—Nonprofit

WINNER: AARP, D.C. Health Law GuideTurning the Affordable Healthcare Act into a plain language explanation was a major effort that most likely involved tough negotiations with lawyers. This interactive tool is very well done with semi-customized answers and short sections with bullet points in plain language. The site is a good example of “less is more” when it comes to design and navigation. The rollover pop-ups with clear definitions of technical terms are a bonus. The tone is neutral and professional and hits the right note with its “direct” talk. The writing is clear and concise and delivers on its promise to make the explanation quick and easy. This site is a good example of how a user-centric approach to design and a strong commitment to clear language come together to create a useful site.

  • ClearMark of Distinction: Educaloi, Quebec, Canada. Educaloi’s website.
  • ClearMark of Distinction: Crime Prevention Ottawa, Canada. Neighbourhood Toolkit.

 

WebPrivate Sector/Corporation

WINNER: Aetna, Hartford, CT. Writers’ Center for Excellence. This is an excellent website about plain language that actually uses plain language. The website is beautifully designed–clean, not cluttered with large and irrelevant pictures, and it practices what it preaches. The audience is well defined in the title, and again in the first paragraph. The tone is helpful, professional, and respectful. The design has a strong color scheme, large type, and great use of space. The judges said they could see how the examples and step-by-step instructions are a great resource for Aetna writers. The structure and navigation are clear, purposeful, and inviting. Overall, the judges said this is a brilliant example of plain language in action.

  • ClearMark of Distinction: Unum, Chattanooga, TN. GetBenefitSmart.
  • ClearMark of Distinction: Cigna, Bloomfield, CT. Cigna Health Care Professional Directory.

 

WebPublic Sector/Government

WINNER: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, D.C. Healthfinder.gov. The judges felt this site was way ahead of other public healthcare sites. The user knows exactly what the site is about and who the intended audience is from the first glance. The site uses everyday words to make the content plain and clear, and the familiar tone helps users navigate the content and provides useful information. The site is consistent from a layout perspective with a good use of space and color to drive the user’s attention. Graphics, including pictures, are thoughtfully used to enhance the text. One judge said they will use this website as an example in courses they teach. The accessible content and easy structure combined with the attention to minorities serve the site well. The information is well written and follows the principles of plain language.

  • ClearMark of Merit: Hennepin County, MN. Absentee Voting. 
  • ClearMark of Merit: U.S. Department of Agriculture, D.C. Introduction to Plain Language Course.

 

Multimedia

WINNER: EmmiSolutions, LLC, ChicagoEmmiTransitions: Heart Failure Series. The judges said this organization understood how to make the material speak to the reader. This is an excellent tool that uses plain language to reach a diverse audience by incorporating interactive technology to allow even those unfamiliar with it to get the information. Although the material is about complex health topics, the language is easy to follow with active verbs, short sentences, and simple sentence structure. The tone is friendly, respectful and warm. One judge said it sounds like a helpful and trustworthy nurse or doctor taking the necessary time to explain complex health issues to a patient.

  • ClearMark of Distinction: Healthwise, Boise, ID. Diabetes Stay in Your Target Range.
  • ClearMark of Merit: Aplastic Anemia and MDS International Foundation, Rockville, MD.Standing Up for Your Health.

 

While the ClearMark Awards honored the best examples of plain language communications, the WonderMark Awards were presented to the submissions that reflect the worst or most unclear language. According to Dr. Cheek, the awards were named WonderMark because it makes one ask, “I wonder what they were thinking when writing this?”

In addition to the Grand WonderMark Award recipient, Charles Schwab, New York City, here are the other WonderMark recipients:

  • Department of Homeland Security, D.C. DHS form about consideration of deferred action for childhood arrivals. The judges said the form was written in such a bureaucratic style that someone who was born and raised in this country might not recognize the language as English. Even ignoring the 81-word sentence in the opening paragraph, the focus seems to be more about what Homeland Security does than about what the reader needs to know. The Q&A section, which is typically designed to answer the readers’ questions, left one judge dumbstruck. The submitter said that it is an example of lawyers writing legalese with no consideration of their audience. They explained their submission stating “…using legalese that most of your target audience doesn’t understand makes the program inaccessible to the people it is intended to help.”

 

  • Feldman ENT Group, PC, Chevy Chase, MDConditions of registration The judges said this document was “perfectly dreadful,” especially since it’s given to individuals who may be anxious about their upcoming medical diagnosis, condition and treatment. The submitter said the information was almost impossible to read and the small print made it even more challenging. The submitter added there is no expectation by the physicians that their patients will read or understand this information and admitted that they themselves read only one section. One judge felt that the phrase physician “do no harm” should also include “lawyers and bureaucrats do no harm either.” Another judge added, “A doctor’s office is a place that’s supposed to make you feel safe and cared for. Imagine how patients feel trying to figure out exactly what they are authorizing and consenting to just to make the doctor feel safe.”

 

  • 1&1 Internet, Philadelphia, PA. Webhosting upgrade letter. This website hosting company markets its services to nonprogrammers and allows technical novices to create and manage websites. The judges said the letter was excessively wordy and that the additional words only serve to confuse the reader. The submitter felt that most of the company’s 10 million clients wouldn’t have any idea what this specific webhosting upgrade letter means. The submitter has a law degree, yet said she didn’t understand any of the technical terms and was unfamiliar with the technical applications mentioned–except for WordPress. The submitter said, “From the layout to calling me “Mr. Portland” (my hometown, but not my name), to poor grammar, the letter is a disaster for the portion of its 10 million clients who are not computer programmers.”

Judges for the ClearMark Awards consisted of an international panel[JL1]  of plain language experts and others interested in plain language. For more information on the 2014 ClearMark or WonderMark nominations, or the 2014 award submissions, go tohttp://www.centerforplainlanguage.org/awards

 

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Center for Plain Language (centerforplainlanguage.org)

Printed April 20, 2014

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