Tag Archives: Medical Marijuana

I.I.I. Report: Patchwork of state marijuana laws causing headaches for employers, insurers

Today Illinois Governor J. B. Pritzker is reportedly going to sign into law a bill that legalizes recreational marijuana in the state. That makes Illinois the eleventh state (plus D.C.) to legalize marijuana for adult use.

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But as medical and recreational marijuana legalization spreads, concerns about what this means for workplace safety and workers compensation continue to grow. What is the impact of legal marijuana on workplace safety, employer duties and obligations and workers compensation insurance?

Today, the I.I.I. published a report that examines the current state of the issue. (Download the report here.)

Haze of confusion: How employers and insurers are affected by a patchwork of state marijuana laws” dives into the following questions:

  • How does marijuana intoxication work and how might it impact workplace safety?
  • What accommodations, if any, are employers expected to provide for workers that use marijuana?
  • Does workers compensation insurance provide benefits to injured employees testing positive for marijuana? What about reimbursement to injured workers for medical marijuana?

Unfortunately, none of these questions have straightforward answers. Every state’s laws and regulations governing these issues are different, not to mention that federal law prohibits marijuana outright. To complicate matters further, state laws and regulations are constantly changing. Employment and insurance activities once prohibited are often now permitted – or required.

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Legal marijuana isn’t going away. Employers and insurers will continue to grapple with a rapidly changing environment, perhaps for years to come.

To learn more, download the report here.

Medical marijuana is not a prescription drug

marijuana is a drug, but not a “drug”

I’m going to get a little wonky here, bear with me.

The standard homeowners insurance policy only explicitly mentions the word “marijuana” once: to exclude it from liability coverage. Basically, the policy says that the insurer won’t pay for any bodily injuries or property damage to another person arising out of any controlled substance, including marijuana.

But there’s an interesting wrinkle to this. The exclusion also states the following: “However, this exclusion does not apply to the legitimate use of prescription drugs by a person following the orders of a licensed physician.”

“Wait,” you say. “Isn’t there a conflict here? Wouldn’t the policy cover damages from medical marijuana, since it’s a prescription drug?”

Sorry to rain on your parade, but the answer is no.

All together now: Medical marijuana is not a prescription drug

You can be forgiven for thinking that medical marijuana is a prescription drug. After all, that’s how it’s often described by news outlets the world over: Wall Street Journal, New York Times, Washington Post, etc.

But medical marijuana is not a prescription drug under any state’s current medical marijuana program.

Physicians don’t “prescribe” marijuana like they do painkillers and other drugs. Rather, physicians will “certify,” “recommend,” or “authorize” (the exact wording depends on the state) that a patient qualifies under a state program to purchase marijuana products. Often this qualification depends on whether a patient suffers from any of a list of “qualifying conditions” – which vary by state.

With a “recommendation” in hand, the patient can then purchase medical marijuana products from a dispensary, subject to various state-specific limitations (like how much marijuana they can buy in any given month).

“Prescription”, on the other hand, has a specific meaning. The Kansas City Medical Society notes that medical drugs are supported by years of study that can provide guidelines for dosages and plans of care. The U.S. Food and Drug Administration regulates these drugs. Patients with a prescription receive these drugs from a certified pharmacist.

Not so with marijuana. Though some states do require physician dosage recommendations, these are not well understood. The FDA has “not approved marijuana as a safe and effective drug for any indication.” Medical marijuana dispensaries are not pharmacies. They don’t employ pharmacists. The people selling the marijuana are basically like knowledgeable sommeliers at a fancy liquor store.

As we saw above, this distinction has insurance implications. As another example, consider workers’ compensation insurance: do these policies reimburse for an injured worker’s medical marijuana? The answer is far more complicated than you’d think.

One more time: medical marijuana is not a prescription drug.

Some Facts About Medical Marijuana

Insurance Information Institute chief actuary James Lynch reports from last week’s Workers Compensation Research Institute (WCRI) conference: 

I shock no one, I hope, by saying the nation’s attitude toward marijuana has loosened. More than half the states allow marijuana use, either as a medicine or just for fun. The federal government still forbids its use.

It’s a tough spot for insurers. Auto insurers worry that high drivers will cause auto accidents. Workers compensation workers are concerned that high employees will cause work accidents. Insurers want to obey the law, but federal law conflicts with the law in most states.

There are also questions about using marijuana to treat pain, as an alternative to opioids.

Not surprising that weed was the topic of conversation several times at last week’s WCRI conference in Boston.

Alex Swedlow of the California Workers Compensation Institute noted the following:

  • Six states require workers comp insurers to reimburse injured workers who use medical marijuana: Connecticut, Maine, Massachusetts, Minnesota, New Jersey and New Mexico.
  • Six states forbid insurers from reimbursing for medical marijuana: Arizona, Colorado, Michigan, Montana, Oregon and Vermont.
  • The federal laws against marijuana mean it is illegal to use the banking system to purchase marijuana. So an insurer can’t write a check against to pay for the drug. They use cash.

Dr. Dean Hashimoto of the Massachusetts Department of Industrial Accidents provided these facts. They are taken from a National Academy of Sciences report published in January, which is itself a summary of all research on the issue:

  • There is conclusive evidence or substantial evidence that marijuana:
    • Improves the lot of adults in chronic pain.
    • Increases the risk of motor vehicle crashes.
    • Increases the risk of developing schizophrenia and other psychoses.
  • There is moderate support suggesting that marijuana:
    • Improves short-term sleep outcomes for people with fibromyalgia or chronic pain.
    • Increases impairment of learning, memory and attention span.
    • Increases dependence on alcohol, tobacco and illicit drugs.
  • It is not possible to determine whether marijuana use is statistically correlated with occupational injuries.

The California WC report is here www.cwci.org/document.php?file=3090.pdf. The National Academy of Sciences report is here.