Medical Marijuana Legalization and Its Impact on Workers’ Compensation Claims

Medical Marijuana Legalization and Its Impact on Workers’ Compensation Claims

This article examines the legalization of medical marijuana and how it could impact workers’ compensation claims.

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As a medical record review company providing support to medical-legal professionals, we keep track of significant developments related to the medical-legal industry and the ongoing effort to legalize the use of medical marijuana is one such interesting development. In the November 2016 elections, medical marijuana was approved via four state ballot measures. With this, medical marijuana in one form or another has become legalized in 28 statesand the District of Columbia. Some states have legalized only cannabidiol, a particular component of marijuana and continue to prohibit the compound THC that makes a user feel high. What interests us is the impact this legalization may have on workers’ compensation claims. In other words,will medical marijuana treatment become compensable in states that have legalized medical marijuana use?The problem is that under the Controlled Substance Act (CSA) of 1970, marijuana is still classified as a Schedule I substance that makes it illegal at the federal level.

Coming to workers’ compensation cases, payment for marijuana treatment (if an employer/insurer is required to reimburse) would differ on a state-by-state basis. 

New Mexico and Maine are two states that have declared marijuana treatment compensable.

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Other states like California and Arizona have declared that marijuana treatment is not compensable, irrespective of laws in both states allowing some extent of legal marijuana use. In fact, Arizona has passed a law specifically stating that self-insured employers and workers’ compensation insurers are not required to pay for medical marijuana treatment.

Factors that Could Impact Workers’ Compensation Claims There is no definitive answer right now regarding whether medical marijuana would have to be covered as part of workers’ compensation claims. However, it is important to consider certain factors that may have an impact on workers’ compensation claims. 

Insurers depend on evidence-based guidelines when they determine compensation for medical treatments. At present, medical marijuana is not included in any standard workers’ compensation treatment guidelines such as the American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines or the Official Disability Guidelines (ODG). Therefore many payers choose to categorically deny coverage.

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Medical marijuana is not approved by the FDA. The FDA does not view this drug as effective or safe.

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The use of marijuana at the workplace may have a negative impact taking into consideration

the

federal

drug-free

workplace

programs

under

which

many

employerswho receive federal funds are required to establish a comprehensive program to deal with illicit drug use in the workplace and also use random drug tests to identify users. Other businesses can opt to implement a zero-tolerance drug policy. 

There is always the risk of marijuana negatively affecting work performance of employees who are treated with this drug. It can affect balance and coordination and impair cognition, reduce alertness and delay reaction time. Needless to say, this is risky for employees who may have to operate heavy machinery or drive vehicles as part of their job. Marijuana can also increase job turnover and absences from work.

So is there a good side to medical marijuana? 

Medical marijuana could prove to be a solution for chronic pain that affects around 100 million U.S. adults. Pain treatment costs are estimated at $635 billion each year in treatment and lost productivity. Opioid prescription painkillers lead to abuse and many opioid-related deaths are reported each year. It is in this scenario, that medical marijuana’s use is considered a solution. Studies, though in a small scale, have shown positive results for its ability to relieve pain. When used with opioids, it could lower opioid dosage and abuse.

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In New Mexico, a court ruled that the workers’ compensation insurance company reimburse an injured worker for medical marijuana treatment. Such examples illustrate the positive side of medical marijuana, especially in cases where the patient does not respond to other standard medications and is in considerable pain.

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National polls show that an increasing number of Americans, even as much as 78% believe that medical marijuana with a physician’s recommendation ought to be legal.

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States that have legalized medical marijuana are seeing a significant amount of tax revenue being collected. In Colorado, marijuana is legalized for medical and recreational use and the state received a tax revenue of 69 million dollars in 2014. It is expected that such instances may persuade the federal government and the remaining states to approve medical marijuana.

Meanwhile, many bills are being proposed in Congress to change marijuana’s classification from a Schedule I to Schedule II substance, recognizing that it has “accepted medical use.”

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What about Coverage?

In most U.S. states, the law says that workers’ compensation must cover what is reasonable and necessary and also proven to be “efficacious.”In short, it seems that 

Workers can seek reimbursement for medical marijuana unless the state has a statutory provision that especially prohibits medical marijuana reimbursement.

Employers and insurers will have to closely study their particular legislative framework when making compensability determinations for medical marijuana claims.

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In states that have not legalized medical marijuana, employers and insurers can deny reimbursement for now. However, it is important to note that every year new medical marijuana legislation is being proposed.

Meanwhile, employers should carefully review their employee handbook and personnel policies with the help of legal counsel and HR professionals. They must clearly inform their workers about their expectations regarding medical marijuana. They must establish good workers’ compensation policies in collaboration with insurers, third-party administrators and pharmacy benefit managers. They should also stay updated regarding judgements, verdicts and new cases as well as relevant political and public trends.

www.mosmedicalrecordreview.com

(800) 670 2809