In a state where medical marijuana is legal, a recent court decision has reinforced a previous one regarding pot prescriptions under workers’ comp.
Miguel Maez suffered injuries to his lumbar spine in February and March 2011 while working for Riley Industrial in New Mexico.
Maez received temporary disability benefits under workers’ comp. Dr. Anthony Reeve treated him for back pain starting in June 2011 and prescribed medication for pain management. He also referred Maez to another doctor for spinal injections.
During a test required for pain management patients, Maez tested positive for marijuana. Dr. Reeve told Maez that if he was going to continue to take marijuana, he needed to have a license for Dr. Reeve to continue administering other narcotics.
In February 2012, Dr. Reeve saw Maez for a medical marijuana evaluation. Dr. Reeve stated Maez had received spinal injections and chronic pain management and “had failed traditional pain management and is a candidate for the cannabis program.” At the time, the doctor had been prescribing hydrocodone, an opioid, for Maez.
In April 2012, Dr. Reeve authorized medical marijuana for Maez for one year. He re-authorized Maez for the medical pot program after a re-evaluation in April 2013. Once again, the license was valid for one year.
Maez filed for workers’ comp to cover the cost of the medical marijuana.
A workers’ compensation judge (WCJ) found Dr. Reeve didn’t prescribe medical marijuana and concluded that the pot program wasn’t reasonable and necessary medical care as required by workers’ comp. (More about that in a moment.)
Maez appealed the WCJ’s decision to the New Mexico Court of Appeals.
If it’s not a prescription medicine …
The Court of Appeals had ruled in a previous case that the New Mexico workers’ comp law authorized reimbursement for medical marijuana use as allowed in the state’s Compassionate Use Act. Two things were required:
- The person must be qualified to participate in the Department of Health Medical Cannabis Program authorized by the Compassionate Use Act, and
- Treatment with medical marijuana must be “reasonable and necessary” medical use.
Maez said the WCJ erred because medical marijuana is reasonable care for a worker’s chronic low back pain. Specifically, Maez argued the ACJ incorrectly found Dr. Reeve didn’t prescribe marijuana for him.
Just how did the WCJ come to the conclusion that Dr. Reeve didn’t prescribe medical marijuana for Maez? It was a technicality. Medical marijuana isn’t a prescription drug. Therefore the WCJ found Dr. Reeve hadn’t “prescribed” medical pot for Maez.
But in a previous case, the appeals court had found the certification required under the Compassionate Use Act by a person licensed in New Mexico to prescribe and administer controlled substances is the functional equivalent of a prescription.
Therefore, the court found medical marijuana was reasonable care for Maez. Dr. Reeve had treated him previously with traditional pain management that had failed. Then he adopted a treatment plan based on medical pot. “He would not have done so if it were an unreasonable medical treatment,” the appeals court found.
But the court still had to determine whether medical pot was necessary for Maez. The court said making that determination was more difficult.
Dr. Reeve didn’t testify that medical marijuana was necessary for Maez’s care. In his deposition, Dr. Reeve stated Maez was already using marijuana and that he would sign for it if that’s what Maez wanted. He specified that if he did so, that wasn’t a recommendation for marijuana use. He considered the medical marijuana program to be a patient’s decision “as it’s private and voluntary and it’s not overseen by a physician.”
However, Dr. Reeve did OK medical marijuana as his treatment plan for Maez. The court said that was clearly evidence to support that medical pot was necessary for treatment of Maez’s chronic back pain.
For those reasons, the appeals court reversed the WCJ’s ruling and said the company’s workers’ comp insurance should pay for Maez’s enrollment in the medical marijuana program for his chronic back pain.
What do you think about the court’s decision? Let us know in the comments.
(Miguel Maez v. Riley Industrial, Court of Appeals of new Mexico, No. 33,154, 1/13/15)
