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Medical Marijuana in Florida Workers’ Compensation Claims

Medical Marijuana in Florida Workers’ Compensation Claims

Medical Marijuana in Florida Workers’ Compensation Claims

In 2016, the medical use of marijuana was legalized in Florida by 71% of the vote. While the implementation followed slowly, medical patients are finally able to use marijuana to treat their various ailments. As Florida workers’ compensation injuries can necessitate pain medication, it is a natural question to wonder if medical marijuana is covered under Florida workers’ compensation.

Unfortunately, as of the writing of this blog on 11/25/2023, medical marijuana is not a covered treatment under Florida workers’ compensation insurance.

This issue of Medical Marijuana in Florida Workers’ Compensation Claims went before the First District Court of Appeal and the issue was decided on June 30, 2021. Jones v. Grace Healthcare, 320 So.3d 191(Mem) (Fla. App. 2021).

In that case, Patrick Shawn Jones challenged the denial of his petition for benefits by a Judge of Compensation Claim. The petition sought authorization for what Jones characterized as a “referral for Medical Marijuana.” The court held that “Under Florida law, marijuana is not reimbursable within our worker’s compensation system. Moreover, extant federal law—which we are oath-bound to follow—characterizes marijuana as having no accepted medical use and makes all possession and use of it illegal throughout the United States. In turn, a referral to a physician authorized to prescribe medical marijuana, including even just for an evaluation of whether the employee is a good candidate for marijuana treatment, could not—under any circumstances—be “medically necessary,” as that term is defined and used in section 440.13, Florida Statutes.”

In Mr. Jones situation, he was injured in 2001 and was under the long term care of a pain management physician for chronic pain syndrome who treated him with oral pain medications. His pain management physician wrote a referral to a doctor qualified to examine Jones and write him a certification to access marijuana in accord with subsections three and four of section 381.986, Florida Statutes (2018). Jones sought authorization for that referral, and the insurance company denied the request.

In Florida Workers’ Compensation claims, the Authorization of Medical Care in Florida Workers’ Compensation Claims is sent to the employer/carrier for approval or denial. Any medical care must be “medically necessary” as defined by Florida Law. Under F.S. 440.13(1)(k) “Medically necessary” or “medical necessity” means any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient’s diagnosis and status of recovery, and is consistent with the location of service, the level of care provided, and applicable practice parameters. The service should be widely accepted among practicing health care providers, based on scientific criteria, and determined to be reasonably safe. The service must not be of an experimental, investigative, or research nature.”

The Florida Legislature, in enacting the legalization of medical marijuana, specifically set forth that marijuana “is not reimbursable under chapter 440.” § 381.986(15)(f). The court concluded that because it is explicitly cut out of the Workers’ Compensation act, by definition, it cannot be medically necessary.

Tampa Workers Compensation LawyerIn Florida Workers’ Compensation claims, the Authorization of Medical Care in Florida Workers’ Compensation Claims is up to the employer/carrier for approval or denial. Any medical care must be “medically necessary” as defined by Florida Law. Under F.S. 440.13(1)(k) “Medically necessary” or “medical necessity” means any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient’s diagnosis and status of recovery, and is consistent with the location of service, the level of care provided, and applicable practice parameters. The service should be widely accepted among practicing health care providers, based on scientific criteria, and determined to be reasonably safe. The service must not be of an experimental, investigative, or research nature.”

As stated above, unfortunately, Medical Marijuana is not covered under Florida workers’ compensation claims. If you have questions regarding the Authorization of Medical Care that is covered in Florida Workers’ Compensation Claims, feel free to contact our office for a free consultation. It is important that an injured worker learn his or her rights and what is and is not covered, as denials can be challenged.

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