As the legalization of medical marijuana spread across the U.S., alongside it grew a grey area concerning its use by injured workers and how it would be handled by the workers' compensation system. While a number of state courts have tackled issues around marijuana and workers' comp, the U.S. Supreme Court opted to punt on the topic. In June 2022, the court declined to hear two cases from Minnesota dealing with medical marijuana. As it stands, Minnesota is now one of six states that explicitly allow for workers' compensation reimbursement for medical marijuana, according to the American Academy of Actuaries. The above slideshow highlights the other states that allow for medical marijuana reimbursement under workers' comp as well as those that expressly prohibit reimbursement. According to the American Academy of Actuaries, 14 states have determined — either through statute, court decision or administrative ruling — that insurance carriers can't be required to reimburse an injured worker for medical marijuana, leaving open the possibility that reimbursement could be made on a voluntary basis. A carrier might choose to offer coverage for medical marijuana as it can be "significantly cheaper than narcotics and opiates," according to Julie Schum, a partner at Quintairos, Prieto, Wood & Boyer. In 2022, 32% of workers' compensation claims had an opiate prescription and 27% had more than one, Schum said at the 2023 RiskWorld conference. "One of the most expensive facets of any workers' compensation case is the ongoing prescriptions for narcotics and opioids," Schum said. The Commonwealth Court of Pennsylvania ruled in Marsh 2023 that while a workers' comp carrier could refuse coverage for medical marijuana, nothing in the state's worker's comp act precluded a carrier from reimbursing an injured work for their out-of-pocket medical treatment costs if the treatment is "reasonable and necessary for his work-related injury." The Pennsylvania judges immediately pointed out that "coverage" and "reimbursement" are separate and distinct concepts, and neither was defined in the workers' comp policy. While "coverage" refers to a specific risk included by an insurance policy, "reimbursement" means paying someone back for money already spent, the court determined. Other states that neither expressly prohibit or require payment and reimbursement for medical marijuana include Arizona, Arkansas, California, Colorado, Delaware, Illinois, Louisiana, Michigan, Missouri, Nevada, Oregon, Utah and Vermont, according to the American Academy of Actuaries. Related:

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