iOn March 17, 2023, Pennsylvania’s Commonwealth Court reversed the holdings of Pennsylvania’s Workers’ Compensation Judge (WC Judge) and Workers’ Compensation Board (WC Board) and held that an employee was entitled to be reimbursed for medical marijuana as recommended and deemed necessary by his physician. Teresa L. Fegley, Executrix to the Estate of Paul Sheetz v. Firestone Tire & Rubber, Commonwealth Court of Pennsylvania Docket No. 680 C.D. 2021.
Background
On September 19, 1977, Paul Sheetz was injured during the course of his employment with Firestone Tire & Rubber (Firestone) and received continuing medical reimbursement from his employer. From 1977 forward, he underwent two back surgeries and was prescribed painkillers, including OxyContin. Sheetz began receiving recommendations for medical marijuana in January 2019, and subsequently weaned himself off OxyContin and diazepam. His former employer refused to pay for his medical marijuana treatment, prompting Sheetz to file a workers’ compensation claim and appeals of unfavorable rulings by a WC Judge and the WC Board.
Holdings and Opinions
In the Opinion issued by six of a seven-judge panel hearing the case, the court initially noted the conflict between Pennsylvania state law (which recognizes medical marijuana as a bona fide medical treatment for several conditions, including chronic pain) and federal law (which prohibits any use of or payment for marijuana). The Commonwealth Court held Firestone had not waived a provision of Pennsylvania’s Medical Marijuana Act (MMA), stating that the act does not mandate “insurers” to provide “coverage” for medical marijuana treatment. MMA at 355 P.S. § 10231.2102. The court further found that Firestone could not be excluded from the undefined term “insurer” under the MMA with respect to its duties to provide workers’ compensation benefits to its former employee.
The majority then distinguished between “coverage” and “reimbursement,” finding that while Firestone could not be compelled to provide insurance coverage under the MMA, that act also states that an employee could not be denied a “right or privilege” based on medical marijuana use. MMA at 355 P.S. § 10231.2103(a). It was noted that several states had specifically excluded “reimbursement” from their statutes and Pennsylvania’s failure to do so must be inferred as reflecting an intention that the MMA does not intend to exclude an insurer’s “reimbursement” obligations. Because the MMA recognizes the validity of medical marijuana as a treatment for chronic pain, a WC insurer cannot deny an employee the right to receive reimbursement for medically necessary and legal treatment.
Finally, the court’s majority found that providing reimbursement for treatment prescribed by a physician in accord with the provisions of the MMA would not cause the WC insurer to “manufacture, distribute, or dispense” a controlled substance and, therefore, did not violate federal law.
The majority then remanded the case to the WC Judge to determine whether a penalty should be awarded against the employer in favor of the Estate of its now deceased employee.
In a dissenting opinion, the seventh member of the panel, Honorable Fizzano Cannon, found that reimbursement of medical marijuana treatment does in fact constitute dispensing a controlled substance, and therefore should not be permitted under Pennsylvania law.
The Fegley holding is a matter of first impression in Pennsylvania, and is consistent with similar holdings in New Mexico, New Jersey, New Hampshire, New York and Connecticut.
