Medical marijuana is playing a growing role in helping injured workers manage pain and symptoms after workplace injuries in Pennsylvania. A significant court ruling in March 2023 confirmed that costs related to medical marijuana may now be reimbursed under the state’s workers’ compensation laws.
On March 17, 2023, the Commonwealth Court of Pennsylvania issued a decision requiring insurance carriers and self-insured employers to cover out-of-pocket expenses for injured workers using medical marijuana when it’s recommended for treatment. This is a significant shift that offers new clarity for workers, employers, and insurers alike.
Here are five key facts every Pennsylvanian should know about how this change affects injury claims and medical treatment options.
1. The Court Ruling Requires Coverage of Medical Marijuana Costs
In a 5-2 decision, the Commonwealth Court determined that expenses for medical marijuana should be reimbursed when used to treat conditions resulting from work injuries.
The court examined federal drug laws, the state’s Medical Marijuana Act, and existing workers’ compensation statutes before concluding that state law allows reimbursement, despite marijuana remaining illegal at the federal level.
The decision overturned a prior ruling from the Workers’ Compensation Appeal Board, which had previously found that federal law prevented insurers from covering these costs. This new ruling now makes it clear that Pennsylvania’s own laws guide how medical expenses are handled for injured employees.
2. Reimbursement For Medical Marijuana Depends on Medical Certification
Injured workers aren’t automatically eligible for reimbursement for medical marijuana costs. Instead, certain conditions must be met:
-
A licensed medical provider must recommend or certify the use of medical marijuana under the Pennsylvania Medical Marijuana Act.
-
Expenses must be properly documented, including receipts and records proving they were tied to treatment for a work-related injury.
-
The treatment must relate directly to the health issues caused by the workplace accident.
This means that while coverage is now possible, it’s important for injured workers to keep careful records and follow proper medical guidance.
3. Employers and Insurers Must Adjust to the New Rules
This ruling means that both insurers and self-insured employers in Pennsylvania will need to change how they handle claims involving alternative medical treatments.
They’ll need to:
-
Update their claims procedures to allow for medical marijuana reimbursement.
-
Educate claims staff about reviewing documentation and verifying medical necessity.
-
Plan financially for the potential costs associated with covering this type of treatment.
While this might mean more administrative work for insurers, it offers injured workers more options for pain management and care.
4. Federal Law Doesn’t Prevent Reimbursement Under State Law
A key issue in the case was the conflict between federal law, which still classifies marijuana as illegal, and Pennsylvania’s laws permitting medical marijuana use.
The court determined that federal law does not block Pennsylvania from deciding how to handle medical treatments within its own workers’ compensation system. As long as the medical marijuana use is legal under state law and properly certified, it can be reimbursed as part of medical benefits.
This clarification gives workers and insurers more confidence about how these claims will be handled going forward.
5. Medical Marijuana Ruling Helps Injured Workers Access Modern Treatment Options
For injured workers dealing with chronic pain, anxiety, or other symptoms from job-related injuries, this ruling provides a pathway to cover alternative treatments that might work better for them than traditional medications.
Medical marijuana may help individuals who experience side effects from opioids or want to try different pain management methods. However, navigating these claims can be complex. Injured workers may benefit from legal guidance to ensure their expenses are covered properly.
What Should Injured Workers Do Next?
If you’re recovering from a workplace injury and considering medical marijuana as part of your treatment plan, here are some steps to protect your rights:
-
Talk to your doctor to see if medical marijuana is appropriate for your condition.
-
Keep thorough records and receipts for any related expenses.
-
Seek advice from a lawyer experienced in handling injury claims and medical expense reimbursements under state law.
Understanding your rights under Pennsylvania’s workers’ compensation laws can make a significant difference in your recovery and financial stability.
Need Help With Your Claim?
At YCL Law, we help injured Pennsylvanians understand their rights and navigate complex claims. If you have questions about how medical marijuana costs might be covered in your situation, we’re here to help.
Contact us for a free consultation. Don’t let uncertainty prevent you from accessing the medical care you need after a workplace injury.