Valdes v. Well Path Recovery Solutions / ESIS

HR Law Cases

JCC Medina Shore (Miami) (Brian Ricotta) (6-19-23) – Denied claimant’s Motion for $7,500.00 Advance. The claimant suffered a compensable left knee injury and was placed at MMI with a 1% PIR on July 2, 2019. The following year the claimant made initial complaints of right hip pain. The E/C denied compensability of the claimant’s right hip and the claimant sought unauthorized care with Dr. Van der Ven, who recommended in November of 2022 that she undergo a total right hip replacement. The claimant continued to work full duty for the employer since the date of MMI and filed the motion for advance to cover the approximately $7,000.00 co-pay to have the hip replacement through her private health insurance. The JCC determined that although the advance was in the best interest of the claimant, awarding the advance was not reasonable and would materially prejudice the E/C as there would be no path to recoup the proceeds if the E/C was successful in defending compensability of the alleged hip condition at Final Hearing that was scheduled to take place less than 90 days from the Evidentiary Hearing.

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