Is Medical Marijuana Covered by Workers Compensation in California?
California was the first state to legalize marijuana for medical use – all the way back in 1996. At that time voters passed Proposition 215, also known as the Compassionate Use Act. Under Proposition 215, patients with a qualifying medical condition can use marijuana for medical purposes with a doctor’s recommendation.
But to date only 30 states have followed suit – with Virginia being the most recent to make medical marijuana legal in 2021. And while the medicinal benefits of marijuana have been widely demonstrated in countless clinical studies, medical marijuana is still a controversial topic in the United States.
Even with 3/5ths of the states now legalizing medical marijuana, there has been contentious debate about whether it should be covered as a medical treatment under workers’ compensation. Fortunately, California is at the forefront of the issue of whether medical marijuana is covered under workers’ compensation benefits – and has clearly addressed it in both legislation and court cases.
The short answer is that medical marijuana is covered under workers’ compensation benefits in California sometimes – but only if certain criteria are met. In this article, the experienced workers’ compensation attorneys at the Law Offices of Cantrell Green explain when (and how) injured workers may qualify to have marijuana covered as a medical treatment in California.
California Workers Compensation Laws & Medical Marijuana
First, it is important to understand the basics of California workers’ compensation law. The California Labor Code requires employers to provide medical treatment to employees who are injured or become ill as a result of their employment. This can include treatment for conditions such as chronic pain, post-traumatic stress disorder, and other mental health conditions. But when it comes to medical marijuana, California has taken a unique approach.
In 2010, the California Workers’ Compensation Appeals Board (WCAB) issued a decision in the case of Ogilvie v. City and County of San Francisco. In that case, the WCAB held that an injured worker who had been prescribed medical marijuana for chronic pain was entitled to reimbursement for the cost of the marijuana as a form of medical treatment.
However, the decision in Ogilvie was later overturned by a California Court of Appeal in the case of City of San Diego v. Workers’ Compensation Appeals Board. In that appeals case, the Court held that the federal Controlled Substances Act (CSA) preempted California state law and prevented the reimbursement of medical marijuana under workers’ compensation.
So then, in response to the City of San Diego appeals decision, the California State Legislature took matters into its own hands. In 2018 Senate Bill 1169 was passed, which amended the Labor Code to clarify that medical treatment for injured workers can include medical marijuana, but only under certain conditions. Specifically, the new law requires that the use of medical marijuana must be recommended by a treating physician, and that the physician must provide a written treatment plan that includes the frequency and amount of marijuana to be used.
When is Medical Marijuana Covered by California Workers Compensation?
Under SB 1169, medical marijuana can be covered under workers’ compensation benefits in California, but only under five very specific conditions. These conditions are allegedly designed to ensure that the use of medical marijuana is appropriate, safe, and medically necessary for treating the worker’s injury or illness.
The first condition is that the use of medical marijuana must be recommended by the injured worker’s treating physician. This means that the worker must have a valid physician’s recommendation for medical marijuana use, which is obtained through the state’s medical marijuana program. The physician must also be licensed and in good standing with the Medical Board of California.
The second condition is that the physician must provide a written treatment plan that includes the frequency and amount of marijuana to be used. This treatment plan must be consistent with the relevant medical treatment guidelines, as well as any other applicable laws and regulations.
The third condition for workers comp coverage of medical marijuana is that the use must be consistent with the employer’s drug-free workplace policy. This means that the employer may still enforce its policy prohibiting the use of marijuana in the workplace or while performing work-related duties.
As a fourth condition, the cost of medical marijuana must be ‘reasonable’. The cost of medical marijuana is subject to the same fee schedule and billing requirements as other medical treatment provided under workers’ compensation.
Finally, for the fifth condition the medical marijuana must be used for the treatment of a covered condition under workers’ compensation. This means that the use of medical marijuana must be related to the worker’s work-related injury or illness.
Common Injuries for Which Medical Marijuana is Covered by Workers Compensation
The use of medical marijuana is subject to strict requirements and is not available under workers comp for all types of workplace injuries. Following are some of the most common workplace injuries for which medical marijuana may be covered as a treatment under California workers’ compensation law.
Chronic pain is one of the most common conditions for which medical marijuana is used. Under California workers’ compensation law, medical marijuana may be covered as a treatment for chronic pain caused by a workplace injury. However, the injury must be well-documented, and the use of medical marijuana must be recommended by a treating physician.
Post-traumatic stress disorder (PTSD) may be covered as a workplace injury under California workers’ compensation law if it is caused by a traumatic event that occurred on the job, such as a workplace accident or exposure to violence. Medical marijuana may be covered as a treatment for PTSD if other treatments have been ineffective, and the use of medical marijuana is recommended by a treating physician.
Medical marijuana may also be covered as a treatment for seizures caused by a workplace injury. However, the use of medical marijuana must be recommended by a treating physician and approved by the California Division of Workers’ Compensation.
California Workers Compensation Attorneys
Under California workers’ compensation law, medical marijuana may be covered as a treatment for certain workplace injuries – but it isn’t “automatic” and there are numerous hoops the injured employee has to jump through to obtain these benefits.
Remember, even if all of the conditions of California law SB 1169 are met, the use of medical marijuana may still be subject to review and approval or denial by the workers’ compensation insurance carrier. The carrier may require additional documentation or evidence to support the medical necessity of the treatment or may request a second opinion from a qualified medical examiner.
This highlights why it is so important to have your workers compensation case handled by a skilled and experienced workers compensation attorney.
Your consultation with our experienced airline employee workers’ compensation attorneys is 100% confidential, and neither your employer nor your insurance company will be notified that you requested a consultation with us. Our attorneys will help you understand your rights and work tirelessly to ensure that you receive the maximum workers’ compensation benefits for which you qualify.
California Workers Compensation Attorneys: 800-964-8047