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Is Marijuana Covered by Workers’ Compensation?

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Marijuana rescheduling and legalization have been hot topics of public discussion for many years, and several states, as well as the District of Columbia, have passed legislation decriminalizing marijuana use and providing access to medical marijuana for qualifying patients. While this trend is helping grow a burgeoning industry and offering patients with various medical conditions alternative healthcare options, marijuana’s federal status as a Schedule I controlled substance has raised questions concerning reimbursement for medical marijuana under workers’ compensation laws.

Federal Classification Issues

Marijuana is still a Schedule I controlled substance under federal law, despite several states legalizing medical and even recreational use. This has caused confusion for some insurers when it comes to deciding whether to reimburse medical marijuana patients. Since marijuana remains a Schedule I controlled substance at the federal level, it cannot have a National Drug Code, so there is no standardized reimbursement rate for medical marijuana.

The federal government has thus far only mildly interfered with state’s marijuana laws and as more states turn to legalization and decriminalization, federal laws may change in the very near future. Unfortunately, federal restrictions have made it difficult for researchers to conduct thorough examinations of marijuana’s medical benefits. Some states have pushed legislation to make medical marijuana more accessible to patients that benefit from using it, and others have even decriminalized marijuana possession and use, issuing citations similar to traffic violations instead of conducting arrests for drug offenses.

State Laws

Five states have introduced laws that state medical marijuana patients can receive reimbursement under workers’ compensation benefits: Connecticut, Maine, Minnesota, New Jersey, and New Mexico. Other states have laws expressly prohibiting reimbursement for medical marijuana, but few prevent workers’ compensation insurers from paying for medical marijuana treatment. Florida and North Dakota are the only two states that have passed laws prohibiting medical marijuana reimbursement through workers’ compensation.

Current Proceedings

The Maine Supreme Judicial Court recently began hearings for a millworker’s medical marijuana case to determine whether the state will require workers’ compensation benefits to pay for the medical marijuana or if the insurer should face charges as an accessory to federal drug law violations. In 2015, the Maine Workers’ Compensation Board ordered the millworker’s insurance administration to reimburse him for the cost of his medical marijuana.

The millworker, Gaetan Bourgoin of Madawaska, sought reimbursement in 2015 for medical marijuana he uses to treat back pain from a 1989 injury while working at what is now the Twin Rivers Paper Co.

Bourgoin had tried several opioid-based prescription pain medications over the years that provided little to no relief, and attorneys for the Twin Rivers Paper Co. and Bourgoin’s insurer appealed the Board’s decision stating that an insurer cannot be forced to pay for marijuana since it is still illegal under federal law, which supersedes state law. These appellants also argue that reimbursement for medical marijuana under workers’ compensation benefits would violate the Maine Medical Use of Marijuana Act, which states that, just because someone uses marijuana legally, neither government medical assistance programs nor private health insurers have to reimburse medical marijuana costs.

Mr. Bourgoin’s attorney offered the counterargument that state law entitles injured workers to appropriate medical services and medications. Since opioid-based medications failed and marijuana offered a better pain management solution for Bourgoin, his attorney argues that medical marijuana classifies as a medicine in this case. Hopefully, this case and others pertaining to medical marijuana reimbursement for workers’ compensation claims help injured workers obtain the medicines they need without facing legal penalties or excessive red tape.