October 22, 2019

Requesting authorization to treat the chronic pain that a Workers' Compensation benefits recipient was experiencing from his work-related injuries with medical marihuana


The Workers' Compensation Board among other things, sustained the employer's workers' compensation carrier's denial of a claimant's treating physician's "MG-2 Form" requesting a variance to permit treating his work-related injuries with medical marihuana.

A Workers' Compensation Law Judge [WCLJ] subsequently approved the variance request for causally-related medical marihuana treatment following a hearing and submission of additional medical evidence from claimant's treating medical provider which included a medical report in which the medical provider summarized claimant's pain management regimen and reviewed the various "beneficial effects of the medical mari[h]uana" that claimant had received.

The provider reported, among other things, that Claimant's sleep has improved and pain was reduced "since using medical marihuana," that medical marihuana "allowed him to participate more with his wife and children" and that he "[e]motionally feels much improved" as a result of using medical marihuana. The treating medical provider also noted that claimant was experiencing a "[f]inancial burden with continuing an optimal dose of the medical THC."*

The Workers' Compensation Board's reverse and vacated the WCLJ's decision, finding that "it could not approve a variance for treatment already rendered. Claimant appealed the Board's decision.

The Appellate Division, citing 12 NYCRR 324.3 [a], explained that a variance is a treating medical provider's request for authorization of medical care that varies from the Medical Treatment Guidelines, and, generally, the burden of proof to establish that a variance "is appropriate for the claimant and medically necessary shall rest on the [t]reating [m]edical [p]rovider requesting the variance," noting that 12 NYCRR 324.3 [a] [1] provides that "[a] variance must be requested and granted by the carrier, [the] Special Fund, the Board or order of the [Board] Chair before medical care that varies from the Medical Treatment Guidelines is provided to the claimant and a request for a variance will not be considered if the medical care has already been provided."

However, said the Appellate Division, in its view, although the Board properly denied the variance request for medical care, that applied only to the extent such care had already been provided. In contrast, the court opined that in "an instance such as here, however, where the claimant has a chronic pain condition necessitating ongoing treatment, the Board should have addressed the merits of claimant's variance request for prospective medical marihuana treatment."

The Appellate Division then remitted the matter to the Board "for consideration in the first instance of claimant's variance request for prospective treatment."

* Tetrahydrocannabinol [THC] binds with the cannabinoid 1 [CB1] receptors in the brain and produces a high or sense of euphoria. In contrast, Cannabidiol [CBD] binds very weakly, if at all, to CB1 receptors is reported to be able to interfere with the binding of THC and dampen its psychoactive effects.

The decision is posted on the Internet at:

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