Can Medical Marijuana Impact a Workers’ Comp Case in Pennsylvania?

Medical marijuana is legal in Pennsylvania, and it can be used as a doctor-prescribed therapy for many different conditions and injuries.  Pain management is one of the most common uses for marijuana, making it excellent for many workers after an injury.  However, there may be ways that medical marijuana can impact your Workers’ Comp case both at the outset and when it comes to getting medical marijuana covered.

First, injuries that occur when you are under the effects of drugs or alcohol cannot be covered under Workers’ Comp, potentially causing problems for people who already use medical marijuana and get injured at work.  However, there are ways to still get some injuries covered, even if you have a medical marijuana card.  Second, medical marijuana should be paid for as medication if a doctor prescribes it for your work-related injury, but insurance carriers often fight this and pay for it through reimbursement rather than paying the provider directly.  This can potentially put some limitations on how your case needs to proceed.

Call our Certified Pennsylvania Workers’ Compensation Lawyers at Cardamone Law at (267) 651-7945 for help with your case.

Does Using Medicinal Cannabis Block Me from Filing a Workers’ Comp Claim in Pennsylvania?

Workers’ Compensation is supposed to cover any and all work-related injuries, no matter the source, as long as they were caused by accident.  The Workers’ Comp Act has a carve-out barring claims where the injury was caused by the worker’s own intentional acts, intoxication, or illegal drug use.  The question here is whether the use of medical marijuana is considered “illegal use of drugs” under § 301 of the Workers’ Comp Act.

Being actively under the effects of medical marijuana while at work might not be appropriate.  Additionally, even though medical marijuana is legal in Pennsylvania, it is still illegal under federal law.  Combining these, it is likely that if you were high on medicinal marijuana and that that was what caused your accident, the employer will seek to have your claim denied on the grounds that you were using drugs.

However, our Philadelphia Workers’ Compensation lawyers can still fight these cases.  First, the burden of proof is on your employer to show that you were using drugs in the first place.  Second, they need to prove that it actually caused your accident and that it would not have happened if you were sober.

Does Having a Medical Marijuana Card Prevent Me from Filing for Workers’ Comp in Pennsylvania?

Many people across the state use medical marijuana to treat other health conditions like glaucoma or cancer that might have absolutely nothing to do with their jobs.  Using medical marijuana or having a medical marijuana card on its own should not automatically disqualify you from Workers’ Compensation.

First, like the situation discussed above, an employer needs to show that your accident was actually caused by illegal drug use to block benefits.  If you did not actively have marijuana in your system, then they will have no grounds to claim your drug use caused the accident.

Second, the Medical Marijuana Act has antidiscrimination protections that prevent the Commonwealth or employers from discriminating against employees solely because they have a medical marijuana card or use medicinal cannabis.  If the injury had nothing to do with you using medical marijuana, then they cannot deny your Workers’ Comp claim just because you have a medical marijuana card.

One caveat to take note of here is that metabolites of marijuana can linger in your system for days and weeks after use.  You might not be high now or when the accident happened, but you may have had a high enough concentration of marijuana metabolites in your system at the time that it would be illegal for you to drive or operate heavy machinery, for instance.  If this was the case, your employer might try to deny your claim based on documented, tested drug use, not merely being a medical marijuana user.  In that case, our lawyers will have to fight their assertions out in court.

Can You Get Medical Marijuana Under Workers’ Compensation in Pennsylvania?

Medical marijuana is in a bit of a strange position when it comes to being paid for with Workers’ Comp benefits.  Medical marijuana can legally be prescribed to treat a work injury, and many patients see it as incredibly helpful for treating their condition.  As long as your doctor provides medical evidence showing that this treatment is necessary for your condition, it should be approved and paid for as part of your claim, but the method for having the drug paid for is odd.

Many medications and medical services can be billed directly to your employer’s Workers’ Comp insurance carrier, meaning that the money for your treatment goes straight to your doctor or provider rather than having you pay for it and get reimbursed later.  Medical marijuana is still illegal under federal law, and insurance carriers cannot be forced to “cover” it under the terms of the Medical Marijuana Act.  However, the Commonwealth Court in a 2023 case called Fegley v. Firestone held that insurance carriers can be forced to “reimburse” patients for medical marijuana.

This means you need to get a doctor to sign off on your medical marijuana card and prescription, then you go get the prescription filled at a dispensary, save your receipts, and submit them to the insurance carrier for reimbursement through Workers’ Comp.

Problems Getting Medical Marijuana Reimbursed Under Pennsylvania Workers’ Compensation

Getting medical marijuana through Workers’ Comp can result in some potential challenges.  First, the insurance carrier might be reluctant to pay for it, and you might need to undergo “utilization reviews” to prove that you need this prescription.  Second, because you need to submit for reimbursement after getting medical marijuana, it might be harder to calculate and account for the cost of this prescription up front, especially if the need for medical marijuana develops later in your treatment process or your dose schedule is not yet known.  This might make it harder to include this cost in calculations for settlements, potentially making it less convenient to settle your case for a lump sum early on.

Call Our Pennsylvania Workers’ Comp Lawyers Today

For a free case assessment, call Cardamone Law’s Delaware County, PA Workers’ Compensation attorneys at (267) 651-7945.