Medical Marijuana in Workers’ Compensation

Medical Marijuana white paperMedical marijuana laws and regulations continue to be a hot topic in legislatures across the country and in the workers’ compensation industry. Each state has been unique in its approach to medical cannabis, with certain states imposing restrictions and or specified illnesses for utilization, while others allow broader use of the substance.

The US Food and Drug Administration (FDA) has not approved marijuana for treating any health problems, and there are currently no accepted medical uses. However, according to a New England Journal of Medicine study in coordination with the Center for Disease Control (CDC) from over 2,000 nurse practitioners, oncologists, doctors, and internists regarding pain treatment, medical marijuana received a 73% approval rating. Access to the substance has also been tied with decreased opioid addiction and fatality. An August 2019 study by the University of Massachusetts Amherst and Colorado State University researchers found legalization and greater access to marijuana reduced annual opioid mortality in the range of 20% to 35%.

Although 36 states and counting have legalized medical marijuana, the substance is still prohibited by the federal government and classified as a schedule I drug. However, worries from state regulators have been primarily quelled by the US Department of Justice’s (DOJ) continued federal policy of noninterference with state medical marijuana programs. Today, workers’ compensation systems struggle with whether reimbursement for medical cannabis should be permitted. Even in states where cannabis is legalized for medicinal and recreational purposes, such as Colorado, workers’ compensation boards may deny reimbursement for medicinal marijuana, demonstrating the complexity of the subject.

States such as Florida and North Dakota have explicitly created laws excluding medical cannabis from their workers’ compensation systems. While there have been attempts to find a legislative pathway for reimbursing medical cannabis under workers’ comp, most if not all proposals have fallen flat in most states. With conflicting state and federal legislation and regulations, the courts have primarily decided whether medicinal marijuana is reimbursable under workers’ compensation in each state.

Maine and Massachusetts have affirmed court decisions against reimbursement for medical cannabis under workers’ comp, citing the federal prohibition on the substance. Meanwhile, courts in New York and New Hampshire have ruled the opposite. Both New York and New Hampshire courts found that the state does not preclude an insurer from covering medical marijuana. Further, each court determined that if the state were going to exclude medical cannabis from being compensable under workers’ compensation, then the state would have explicitly said so in existing legislation as seen in Florida. New York and New Hampshire reaffirmed their decisions as recently as early 2021. Connecticut, New Jersey, and New Mexico have also found that medical marijuana was reasonable and necessary to treat injured workers’ injuries.

Regardless of court rulings and legislation, there remain concerns for medical marijuana in the workplace. Many companies institute drug-free work zones, and an injured worker using medical cannabis for rehabilitation may violate this policy. Guidelines from private industry policies must also be taken into account.

Download: Medical Marijuana White Paper

With little legislative success, the question of medicinal marijuana reimbursement under workers’ compensation remains a contentious one and is most likely to be left to the courts. With an ever-changing landscape, ongoing opioid epidemic, and expanded social acceptance of marijuana across the country, the growth of medical marijuana in the workers’ compensation industry seems to continue. Still, any such growth comes with substantial questions, concerns, and challenges.


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