Can CBD Oil Be Reimbursed by Workers’ Compensation in Pennsylvania?

CBD Oil, when prescribed by a doctor for a work-related injury, can be reimbursed by the workers’ compensation in Pennsylvania. With the onset of medical marijuana and now CBD oil, court rulings and regulations are further clarifying the law regarding these alternative medical treatments.

First, let’s take a look at the latest case law regarding medical marijuana. First, when reading the case law, MMA means Medical Marijuana Act.

In 2023, the Pennsylvania Commonwealth Court issued a ruling on a Penalty Petition for failure to reimburse a claimant for medical marijuana purchased as prescribed by the treating doctor. In Fegley v. Firestone Tire & Rubber (Workers’ Compensation Appeal Board), 291 A.3d 940 (Pa. Cmwlth. 2023), the Commonwealth Court ruled in a case that a workers’ compensation insurance carrier has to reimburse an injured worker for medical marijuana that was prescribed by the treating doctor. First, when addressing Pennsylvania law, the Court said;

Given the General Assembly’s clear declaration and intention in enacting the MMA, and the MMA’s unambiguous statutory language, it is free from doubt that the medical marijuana system the General Assembly created for the well-being and safety of patients, including claimants, was intended for them to have access to the latest medical treatments. Any other interpretation would lead to an unintended, absurd result.

The Court further addressed the employer’s defense that doing so would violate federal law.

Accordingly, this Court rules that coverage is different and distinct from reimbursement and while the plain language of Section 2102 of the MMA states that insurers cannot be required to provide coverage for medical marijuana, there is no statutory language which prohibits insurers from reimbursing claimants who lawfully use medical marijuana to treat an accepted work injury when such treatment is medically reasonable and necessary.

The Court next addressed the Defendant’s concerns about marijuana’s illegality under Federal Law.

Because reimbursing Claimant for his out-of-pocket expenses for his lawful use of medical marijuana as a reasonable and necessary treatment for his work injury would not require Employer’s WC carrier “to manufacture, distribute, or dispense, or possess with intent to manufacture, distribute, or dispense, a controlled substance,” 21 U.S.C. § 841(a), Employer’s WC carrier would not violate the Federal Drug Act, or be at risk of facing federal prosecution by doing so.

Next up we take a look at a recent ruling concerning CBD oil.

Here we take a look at a recent Commonwealth Court case Court that specifically addressed a similar issue and petition regarding CBD oil. In Schmidt v. Schmidt, Kirifides and Rassias, PC (WCAB), No. 1039 C.D. 2021 (Pa. Cmwlth. 2023), the Court pointed to the Fegley case using similar rationale that CBD oil prescribed by a doctor is reimbursable and not in violation of Federal law.  The significant part of this ruling is the Court did indeed determine that CBD oil is considered a medicine or medical supply under the Workers’ Compensation Act.

Although not part of the certified record, counsel for both parties acknowledged during oral argument that while this litigation was pending, Employer did in fact submit a UR claim and the reviewer determined that the CBD oil Dr. Murphy prescribed to Claimant was indeed reasonable and necessary.23Accordingly, the Board erred by expressly refusing to define whether CBD oil is a medicine or supply within the meaning of the Act, and this Court holds that CBD oil is both a medicine and a supply for purposes of Section 306(f.1)(1)(i) of the Act.

The Court has made elements are clear for CBD oil being reimbursable. They are:

  1. CBD oil must be prescribed or recommended by a health care provider;
  2. It must be medically reasonable and necessary; and
  3. Must be related to the work injury.

If you have any questions regarding medical coverage or medical treatment or any issue with your workers’ compensation case, Mooney Law provides absolutely free consultations. We stand ready to fight and protect your benefits.  You can contact Mooney Law at 717-200-HELP or 7178-632-4656 to schedule a free consultation.  You can also link to our website page and complete the Schedule a Consultation form.  Finally, please feel free to Like my Facebook page to keep updated.

Mark Buterbaugh

Attorney representing injured workers and Social Security Disability clients in Pennsylvania and Maryland.