The Ontario Workplace Safety & Insurance Board has implemented a new general policy on medical marijuana that will apply to all requests for entitlement to the drug from 1 March 2019.

By: Laura A. Russell and Julie Weller

Firm: Mathews, Dinsdale & Clark LLP

As of 1 March 2019, the Workplace Safety & Insurance Board’s new policy will apply to all requests for entitlement to medical marijuana in Ontario. Prior to this, the Workplace Safety & Insurance Board was adjudicating on a case-by-case basis. This new policy simply means that the Workplace Safety & Insurance Board has formalised its adjudication of this ‘new’ drug, and that the policy will apply to all appeals heard by the Workplace Safety and Insurance Appeals Tribunal (‘WSIAT’).

Workplace Safety & Insurance Board Policy No. 17-01-10, ‘Cannabis for Medical Purposes’ identifies a list of requirements to assess eligibility for medical cannabis. Coverage for medical cannabis through the Workplace Safety & Insurance Board is currently restricted to five specific, clinically established conditions listed below.

To be considered for eligibility, a worker must pass a threshold test; disqualification factors include being under the age of 25 and/or having a current or past substance use disorder.

If the worker is not disqualified, the Workplace Safety & Insurance Board uses the following criteria to assess eligibility for coverage.

1. Qualifying conditions

The worker is diagnosed with one of the following five (5) conditions as a result of a work-related injury or disease:

  • neuropathic pain;
  • spasticity resulting from a spinal cord injury;
  • chemotherapy-induced nausea and vomiting;
  • loss of appetite associated with HIV or AIDS; and
  • pain and other symptoms in palliative care.

2. Clinical assessment

The worker has received an appropriate clinical assessment and has a valid medical document or a written order for medical cannabis from a health professional (physician or nurse practitioner).

3. Treatment options

Conventional treatments for the diagnosed condition have been exhausted.

4. Therapeutic benefit

The potential therapeutic benefits of cannabis for the worker outweigh the risks.

5. Administration and dosage

The dose and route of administration (such as vapourising or taking oils) should be appropriate for the worker, beginning at the lowest possible dose and proceeding slowly. Note: if the approved delivery method is vapourising, the Workplace Safety & Insurance Board may grant entitlement to the equipment (vapouriser every two years) but does not cover any other devices or paraphernalia.

The Workplace Safety & Insurance Board will cover reasonable costs of medical cannabis if the eligible worker obtains it from a licensed holder. The WSIB will not reimburse a worker for cannabis grown personally or purchased from a recreational cannabis retailer.

If entitlement is allowed under a Workplace Safety & Insurance Board claim, the safety and suitability of Return To Work placements or offers will include the potential impairment effect of the cannabis treatment. This would be the same as for any prescribed medication (e.g. opioids). As always, it is important that a worker’s medical practitioner is aware of the job demands associated with the worker’s pre-injury job or modified work so that the safety of the worker and workplace is maintained regardless of whether the Workplace Safety & Insurance Board grants entitlement for the ‘drug’ or not.

For additional information and resources on this topic, see the medical cannabis page and explanatory note on the Workplace Safety & Insurance Board website.

The situation in the rest of Canada

This article discusses how the Ontario Board specifically grants entitlement for cannabis use as of 1 March 2019. Workers’ compensation coverage in Canada is regulated at the provincial/territorial level. New Brunswick and Prince Edward Island also have a specific policy on entitlement to medical cannabis. Other jurisdictions are currently considering such a policy, but the majority consider entitlement to cannabis on a case-by-case basis under existing broader health care entitlement policies. Notably, the Yukon does not currently allow entitlement for cannabis use at all.