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Court Rules Insurers May Reimburse Injured Workers for Medical Cannabis

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A Pennsylvania appeals court ruled last week that the state’s medical cannabis law does not prohibit health insurance providers from reimbursing workers’ medical cannabis treatment costs for work-related injuries.

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A Pennsylvania appeals court last Friday ruled that the state’s medical cannabis law does not prohibit insurers from reimbursing injured workers for medical cannabis in cases where it is used to treat accepted work-related injuries, according to a Business Insurance report. The Pennsylvania Commonwealth Court decision found that the state’s Workers’ Compensation Appeal Board erred when it upheld a decision by Firestone Tire & Rubber to deny reimbursement for the cost of an employee’s medical cannabis. 

The claimant, Paul Sheetz, who is now deceased, used medical cannabis to treat chronic pain linked to a 1977 work injury and used cannabis to wean from decades-long use of prescribed opioids, the report says. 

Jenifer Kaufman, the attorney who represented the Sheetz’s estate, said after the ruling that the decision “is a game-changer for those injured workers who have worked hard to get off dangerous and expensive opioids and are forced to pay the cost of medical marijuana treatment out of their fixed incomes.” 

“I am so excited that the Commonwealth Court, in their wisdom, agreed that workers comp carriers are required to reimburse injured workers who use medical marijuana to treat severe and often life-long injuries.” — Kaufman via Business Insurance 

Kaufman added that the court’s ruling means insurers must cover medical cannabis costs when treatment is deemed “reasonable and necessary,” and that reimbursement would likely only be available in serious or old injury cases where medical cannabis is the “primary treatment modality.”     

Firestone had argued that reimbursing medical cannabis costs would run afoul of federal law; however, the court concluded that it is not a federal crime because insurers are not recommending cannabis themselves. 

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