An Albertan recently achieved a significant victory in their battle for medical cannabis coverage through Workers’ Compensation. On March 19, 2024, the Appeals Commission for Alberta Workers’ Compensation overturned a 2023 decision by the Workers’ Compensation Board (WCB) Dispute Resolution and Decision Review Body (DRDRB).
The Background
The worker’s journey began with a workplace accident in January 2011 when they injured their ankle after slipping on ice. The WCB accepted their claim for a left ankle fracture and Chronic Regional Pain Syndrome (CRPS). However, in March 2015, a case manager denied authorization for medical cannabis, considering it a non-standard medical aid for chronic pain treatment. The worker persisted, and in March 2017, the WCB recognized that their use of medical cannabis was related to the accepted injuries.
The Battle for Coverage
In September 2022, the WCB informed the worker that any extension of medical cannabis coverage would be reviewed based on new policy criteria. To continue coverage, clinical reassessment and functional improvement confirmation were required every three months. The policy emphasized evidence of effectiveness and balanced benefits versus adverse effects.
However, in February 2023, the WCB ruled that the worker exceeded the standard for maximum allowable THC content and daily use. Despite having a designated condition under the new policy, the worker did not meet all criteria for authorization. The worker promptly appealed, emphasizing their long-time physician’s support for cannabis use in managing chronic pain.
The Verdict
The review body upheld the worker’s appeal, recognizing the medical necessity of cannabis for pain relief. The battle for coverage had been arduous, but the worker’s persistence paid off. Now, they can access the relief they need without financial burden.
