Commonwealth Court Case: Reimbursement for costs of medical cannabis?
Commonwealth Court Case: Can workers who use medical cannabis to treat work-related injuries be reimbursed by workers' compensation insurance?
Hi all,
I follow the legal landscape of medical cannabis in PA closely and wanted to share an interesting medical cannabis-related case that was heard in September 2022-- Fegley vs. Firestone Tire and Rubber. Workers' Compensation attorney Jenifer Kaufman presented a case arguing that the claimant's employer (via their Workers' Compensation insurance carrier) should reimburse the worker for costs associated with his use of medical cannabis as part of workers' compensation payments, maintaining that the medical cannabis was a reasonable and necessary medical expense to manage the claimant's ongoing pain after a work-place injury. The case was heard in the PA Commonwealth Court, which is a state-wide appellate court (court of appeals), and was argued in a combined manner with a second, very similar case. Video here:
The second video is the argument from the opposing counsel:
3/17/2023 Update: The Verdict is in and the answer was Yes!
Announcement from Jenifer Kaufman who represented the plaintiff in the case:
“Today, on a day usually associated with green, the Commonwealth Court, in Fegley v Firestone Tire & Rubber (WCAB), 680 C.D. 2021 issued a decision, authored by Judge Covey and joined by all but one dissenting Judge that Section 2102 of PA’s Medical Marijuana Act and Workers’ Compensation Act allow reimbursement of the cost of MMJ used to treat work injuries. The carrier was therefore directed to reimburse my client’s reasonable out-of-pocket MMJ costs.
The Court accepted my argument that coverage and reimbursement are not synonyms. Section 2102 of the PA Medical Marijuana Act (MMA) precludes “coverage” only. The Court explained that coverage is direct payment to a provider while reimbursement is payment to the patient for the cost of treatment that was already incurred and paid for. The legislature also could have opted to preclude reimbursement as well as coverage when writing Section 2102, but did not.
The Court quoted Justice Felix Frankfurter that when legislation should be interpreted as the ordinary man understands them, when the terms are neither defined nor technical. They also noted Section 2103 of the MMA’s protection for patients and the humanitarian purposes of the Workers’ Compensation Act.
The Court also concluded that the act of reimbursement by the carrier would not violate Federal law or the Controlled Substances Act as the carrier would not be manufacturing, distributing or dispending a controlled substance.
Two Judges did dissent. I fully expect an appeal to the PA Supreme Court. I would note that reimbursement is going to be limited to cases where the MMJ use is deemed reasonable and necessary. This is obviously a huge win and I am grateful for all the support I have been provided in this endeavor.”