WC and Marijuana Part 7: For states with an integration of workers’ compensation and medical marijuana programs, what additional costs should insurers cover beyond the drug itself?

This is the seventh in a multi-part series on the effects of the ongoing legalization of marijuana in the worker’s compensation insurance ecosystem. In case you missed them here’s part one, part two, part threepart four, part five and part six. This series is being ran in preparation for a panel on “Legalization of Marijuana and the Impaired Workforce” that the author is moderating at the AmComp Fall Conference in NYC on November 8, 2018. Opinions expressed are those of the author and are not necessarily held by the author’s employer or AmComp. Insurance Nerds readers can save $100 on registering for AmComp with discount code AMCOMPNERDS.

As the trend in some jurisdictions has continued to issue pro-claimant decisions regarding medical marijuana reimbursements, the question becomes what additional supplies associated with marijuana use may be covered as well.  Most states have enacted statutes, or passed case law, which provides claimants medical benefits related to durable medical equipment. Workers’ compensation carriers have been made responsible for miscellaneous items from alcohol wipes to zinc paste, almost anything necessary for treatment of a work-related injury.  Are rolling papers, pipes, or other instruments for used for marijuana consumption covered? Whether or not coverage should be extended to ancillary marijuana paraphernalia needs to be assessed.

Secondly, the issue of “home grows” where patients can cultivate their own marijuana plants is contentious.  Historically, you cannot produce your own medications at home. Unless you are Walter White, most of us cannot manufacture synthetic drugs to alleviate personal ailments.  However, marijuana is a different story. States that have enacted legislation of medical marijuana have included laws that allow patients to grow their own marijuana, usually six plants or so.  For a workers’ compensation injury where opioids are your drug of choice, a patient must see a doctor, must get a script, and must go to pharmacy and so on. There is a trail from manufacturing all the way through a pharmacy fill.  With marijuana, there is a completely new gray area in self-medication. How do you monitor what patients have been growing and using for their injuries? This is one concern that has no clear answer.

While physicians will certainly disapprove of the “do-it-yourself” patient, the carrier position may be different.  As a pure cost-saving measure, helping injured workers set up their own garden of green can reduce the costs of medical expenditures immensely and provide a significant return on investment.  No doctors’ visits no retail price at the dispensary, just a few start-up costs and monthly maintenance. Should federal regulation change, the impact of oversight by the Food & Drug Administration must be considered.  Whether the FDA regulates cannabis as drug or herbal supplement could be a major factor.

Additionally, many states allow claimants to be reimbursed for mileage to and from doctor appointments and trips to the pharmacy to pick up their medications.  If marijuana is prescribed, will the carrier pay for mileage to and from the dispensary? Assuming states allow medical marijuana under the workers’ compensation claim, mileage could be allowed.  While the questions are merely the tip of the iceberg, any discussion about compensability of cannabis in the workers’ compensation system should include a conversation about these benefits and protections as well.

Brian Reardon is a Board Member of AmComp and AVP, WC Claims for Maiden Reinsurance.  He will be moderating the upcoming panel session on “Legalization of Marijuana and the Impaired Workforce” at the AmComp Fall Conference in NYC on November 8, 2018.  Opinions expressed are those of the author and are not necessarily held by the author’s employer or AmComp.

About Brian Reardon MBA,ARM,AIS

Brian Reardon, AVP of Worker's Compensation Claims at Maiden Holdings in Bermuda and NYC. He has over 14 years of P&C experience working on all sides of the industry including carrier, reinsurer, TPA, broker and employer. He holds multiple industry designations and a MBA in Insurance and Risk Management from St. John's University. He's a Board Member at AmComp (American Society of Workers Comp Professionals) and a Fellow at the Claims & Litigation Management Alliance.

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