As of 2016, marijuana use has been legalized in 25 states and Washington D.C. With a growing number of doctors prescribing cannabis to treat a myriad of ailments, it's natural to wonder if workers' compensation pays for treatments involving this drug in states where it has been approved by the government. Unfortunately, it's not covered by this insurance plan. Here's why.
Why Medical Marijuana Treatments Aren't Covered
The primary reason workers' compensation insurance doesn't pay for medical treatments involving cannabis is because marijuana is still classified as an illegal substance at the federal level. Although state governments may have decriminalized the drug, federal law trumps state law whenever there is a conflict between the two. Therefore, to avoid paying for an illegal drug, workers' compensation will typically deny claims for cannabis treatments.
Since workers' compensation is a state-run program, it's technically possible for the insurance provider to approve the treatments involving marijuana based on state laws, despite the drug being considered illegal by the federal government. However, another reason why the company may decline to do so is because cannabis is not approved for medical use by the FDA. This is directly the result of a lack of studies supporting the drug's efficacy, which also contributes to the insurance provider's reluctance to pay for treatments.
While studies have shown that marijuana can alleviate some symptoms associated with various diseases, such as chronic pain, the FDA requires medication for specific treatments to undergo randomized, double-blind, placebo-controlled human clinical trials before they can be approved. At this time, the majority of treatments involving cannabis or medical conditions that marijuana use would help do not qualify for such studies under the FDA's strict guidelines. So FDA approval may be a ways away.
A third reason why workers' compensation will not approve of cannabis treatments is because the employee's use of the drug may run afoul of drug-free workplace programs. Many companies have zero-tolerance drug policies in place. Others are required to institute comprehensive policies about illicit drug use because they receive money from the federal government.
In either event, an employer retains the right to fire employees who test positive for marijuana, regardless of the fact they may be using it to treat medical problems (medical marijuana is not covered by the American with Disabilities Act). Since cannabis use may inhibit claimants' ability to return to or maintain employment, the insurance provider may decline to pay for cannabis treatments to avoid being complicit in preventing employees from working.
Change is Coming
The list of reasons why workers' comp won't pay for cannabis treatments is long, which means it may be awhile before these insurance providers change their minds and cover them. However, there are signs that change may be coming. One New Mexican man was able to get workers' comp to cover his medical marijuana by suing the insurance company in court.
According to available information, the plaintiff was injured on the job and sustained two back injuries. After undergoing different treatments, none of which effectively alleviated his chronic back pain, his doctor approved him for a medical marijuana license. The workers' compensation insurer refused to pay for the cannabis, and the lower court sided with the company. However, the case was appealed, and the appellate court ruled in favor of the plaintiff. The judges stated the New Mexico's compassionate use laws made it possible for marijuana to be treated as a valid prescription, especially in the plaintiff's case when all other treatment options failed.
It may be possible to use the results of this ground-breaking case to compel workers' comp in your state to pay for your cannabis treatments. If your medical marijuana claim was denied by the insurance company, talk to a workers' comp attorney about the issue. He or she can recommend the best course of action to take that may help you get your claim approved. Click here for info on workers' compensation.