In a recent decision, the Commonwealth Court of Pennsylvania ordered an employer to reimburse an individual’s medical marijuana expenses.
The Background
As background, the employee was injured on the job in 1977 (for the same employer involved in this action) and began a nearly three decades long journey of opioid and narcotic use to manage the severe pain. In January 2019, the individual began using medical marijuana with the hope of eliminating the need to continue taking the various other drugs he had been prescribed. In September 2019, a Utilization Review determined the medical marijuana use was reasonable and necessary leading the individual to seek reimbursement for the medical marijuana treatment from his employer. However, the Workers’ Compensation Judge denied the individual’s petition for the reimbursement leading to the court decision at issue.
The Court Case
Analyzing the complex issue, the court aimed to draw a distinction between potential conflicts of state and federal law, while also distinguishing between coverage and reimbursement under the state’s workers’ compensation law. The court determined Pennsylvania’s Medical Marijuana Act (MMA) does not require insurers provide coverage for medical marijuana; however, the MMA did not specifically exclude reimbursement which means an employer may be required under the state’s Workers Compensation Act to reimburse out-of-pocket costs of medical treatment that has been found to be reasonable and necessary for a work-related injury. The court further found that interpreting the law otherwise would undermine the MMA’s intent to provide patient access to medical marijuana.
Finally, the court determined that medical marijuana reimbursement would not cause the workers compensation carrier to violate federal law as it did not require the carrier to manufacture, distribute or dispense a controlled substance. Further, the employer would not be in violation of federal law as it is not prescribing marijuana but rather is reimbursing the individual’s lawful use. The court remanded the matter to the Workers’ Compensation Board to determine whether a penalty should be imposed.