In a groundbreaking decision, the Commonwealth Court ruled that workers’ compensation should cover the cost of medical marijuana for the treatment of work-related injuries. This decision brings hope to those suffering from chronic pain and could significantly impact the future of workers’ compensation claims.
The Two Decisive Cases
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The Sheetz Estate Case: Medical Marijuana as a Lifeline
In the case of Paul Sheetz, who had been injured at work in 1977, medical marijuana provided much-needed relief from years of pain. After suffering multiple back surgeries and relying on opioids and narcotics for approximately 30 years, Sheetz found solace in medical marijuana. According to Judge Anne Covey, Sheetz’s use of medical marijuana not only reduced his need for opioids and narcotics but also provided psychological benefits. Sheetz’s estate continued the case after his death, seeking coverage for medical marijuana through workers’ compensation.
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Edward Appel’s Battle for Reimbursement
Edward Appel, injured at work in 2006, experienced similar relief after turning to medical marijuana. Having weaned himself off opioids in 2018, Appel sought reimbursement for his medical marijuana through workers’ compensation. Like Sheetz, Appel’s initial claims were denied, and the appeals board upheld those decisions.
Victory in the Commonwealth Court
In both cases, the Commonwealth Court reversed the appeals board’s decisions. The court found that although the Medical Marijuana Law states that insurance companies are not required to cover medical marijuana costs, patients should not be denied any rights for its lawful use. The judges further concluded that employers would not be breaking federal law, as they would only be reimbursing patients for their medical expenses.
Dissenting Opinion: The Importance of Legislative Intent
Judge Christine Fizzano Cannon filed a dissenting opinion, arguing that the Medical Marijuana Law’s ban on requiring insurers to cover medical marijuana costs should be the deciding factor. She noted that the Legislature likely did not require coverage because the U.S. Food and Drug Administration has not approved the drug for any medical conditions. Judge Fizzano Cannon emphasized that any change in the law’s policy and balance regarding insurance coverage must come from the legislature, not the courts.
Implications: A New Era for Workers’ Compensation
These Commonwealth Court rulings mark a turning point in workers’ compensation, providing an alternative treatment option for employees suffering from work-related injuries. As the use of medical marijuana becomes more widespread and accepted, it remains to be seen how these cases will impact the future of workers’ compensation and insurance coverage.
