The Workplace Safety and Insurance Board (WSIB) has published its official Operational Policy on Cannabis for Medical Purposes. This policy issues clear guidelines about when the WSIB will pay for medical marijuana to treat workplace injury and illness. It also helps define when and how employees may use medical cannabis in the workplace. These guidelines went into effect on March 1, 2019 and will help you manage workplace medical cannabis use fairly, consistently and legally.
If an employee is injured or falls ill, these WSIB guidelines will help you and your employees know what to expect if and when a doctor suggests medical cannabis as a treatment. The WSIB plans to review the policy again in two years, hopefully smoothing out any issues that continue to cause confusion.
The Basics
In order for medical marijuana to be an option, the WSIB requires users to meet two criteria. The first is an age limit. Employees under the age of 25 are never eligible for medical cannabis treatment. The WSIB also disallows medical marijuana for anyone who currently has or has ever had a substance abuse issue of any kind.
From alcohol abuse to pain-killer addiction, employees who have abused legal or illegal substances in the past are automatically disqualified from receiving medical marijuana from the WSIB. These employees may still have the legal right to receive medical marijuana treatment, but the WSIB won’t pay for it.
Designated Conditions
Science supports the use of medical marijuana for a variety of ailments, but the drug isn’t a panacea by any means. The WSIB specifically outlines five conditions for which the drug is an acceptable treatment. They are:
- Neuropathy and nerve pain
- Spasms caused by spinal cord injury
- Nausea and vomiting resulting from chemotherapy or cancer treatment
- Anorexia caused by AIDS or HIV
- Pain and other issues requiring palliative care
The WSIB will not provide or approve marijuana or cannabidiol (CBD) treatment for any other conditions, injuries, or diseases.
Doctor Approval
Workers may not take it upon themselves to decide that medical marijuana is an appropriate or necessary treatment for their condition. The WSIB requires a qualified medical health professional to examine the person and authorize cannabis treatment. This ensures that medical marijuana is appropriate for both the condition it’s meant to treat and the individual receiving treatment.
If an employee seeks a second opinion, both doctors must approve cannabis as a treatment. This prevents employees from finding a doctor to say “yes” to medical marijuana when their primary physician says “no.”
Other Treatments Have Failed
Medical cannabis is a blessing for those who need it, but it isn’t meant as a first line of defense. The WSIB requires employees to try conventional and established treatments before turning to medical marijuana. Treatment with marijuana and CBD should begin only when other treatments have failed or were poorly tolerated.
A physician must document attempts to help an employee using traditional medical treatments before declaring them a failure. The doctor must note in the patient’s medical record which treatments were tried and with what results. If a treatment proved intolerable, the doctor must note why.
The exception to this rule is palliative care. In a palliative care situation, a doctor has already established that curing a certain illness or eliminating pain is impossible and that symptom management is the only viable treatment.
Employees seeking medical cannabis for palliative care need not meet this requirement.
Assessment and Ongoing Findings
The WSIB requires a physician to approve an employee’s medical marijuana use, but this approval must also have merit. Before approving treatment, the WSIB requires employees to undergo a clinical medical assessment of their condition. The doctor performing the assessment must include measurable findings and specifics in the records, and care must continue after the initial visit.
Doctors must continue to monitor the employee and record progress, documenting the need for ongoing treatment. The WSIB continues paying for all treatments, including medical cannabis, only so long as the employee is benefiting from medical care.
Benefits Must Outweigh Risks
When undergoing any medical treatment, it’s important to weigh both the benefits and the risks. Though it’s considered a natural remedy, this remains true for medical marijuana. The WSIB will approve treatment only when it won’t interfere with other medications or treatments the employee is receiving.
The WSIB won’t approve medical cannabis for employees with a history of substance abuse. They may also deny approval to those with a personal or strong family history of psychosis.
How and How Much
The WSIB requires employees using medical cannabis to take the lowest effective dose possible. The daily quantity of dried medical cannabis must not exceed three grams per day. The milligrams (mg) of THC per day should be no more than 30 mg, and in no case exceed 75 mg.
Get It in Writing
An employee who receives approval to use medical cannabis from their doctor and meets WSIB requirements must also comply with any legal requirements of their province.
Employees must obtain documentation stating that a doctor approved their medical marijuana usage. This information must detail the authorized dosage amount and administration method. The document must also state how much THC the medication contains.
Reimbursement
An employee who meets all these requirements can have the WSIB pay a reasonable fee for their medical cannabis, as long as the drug treats a work-related injury.
To receive reimbursement, the employee must register as a client of, and purchase the medication from, a hospital or fully licensed medical cannabis vendor. The WSIB will not reimburse employees for marijuana purchased at a recreational dealer or grown at home.
Employees must also obtain WSIB approval before purchasing medical marijuana. Even if they meet all the WSIB’s usage criteria, reimbursement will not be issued if prior authorization was not obtained.
The Bottom Line – Workplace Medical’s Perspective
The legalization of cannabis has raised specific issues around the accommodation of medical marijuana use, but more importantly, it has shed light on broader questions related to any prescription or non-prescription drug use in the workplace.
What are the employer obligations? What policies and procedures need to be in place? What are the supervisor’s responsibilities to report suspected impairment? How do you implement and follow up on the policies?
Drugs and alcohol in the workplace are risk management issues for employers, with impacts on health and safety, absenteeism, employee engagement, customer service, and compliance.
We can help your organization by providing a strategic review of your absence management program, developing your drug and alcohol policy, and providing services to implement and manage your policy. Contact us today.