Medical marijuana is all over the news these days as more states seek to decriminalize it and end up grappling with resulting employment issues. Here are a few recent stories:

* New Jersey Compassionate Use Medical Marijuana Act takes effect July 2010, making New Jersey the 14th state to legalize medical marijuana. (Matthew Stoloff’s blog).

* In April the Oregon Supreme Court ruled that Oregon law does not require employers to accommodate medical marijuana that is otherwise allowed under state law. (Jackson Lewis blog).

* California voters will decide in November whether to legalize it. (Associated Press)

* Joshua Clifton wrote an excellent article in Risk Management about the effect of the Oregon decision for workers’ comp and hiring law. (Risk & Insurance)

In these states and many others, employers are beginning to wrestle with issues of prescribed medical marijuana use by employees on STD, LTD, and Workers’ Comp. It’s only a matter of time before its use as a treatment modality becomes a significant return-to-work issue.

If you’re an employer, insurer, TPA or case manager, consider the following:

* Case managers should be aware that employees on short-term and long-term disability in many states may be prescribed medical marijuana, particularly for chronic conditions where more standard treatments have failed. In these cases, the employee may or may not inform the case manager of this.

* While the use of medical marijuana is an alternate treatment, and typically not an approved treatment method covered by insurance, case managers should be aware of the possibility and its potential effects on recovery, return-to-work durations, and especially, the potential for ongoing usage after the employee goes back on the job.

* Disability plan language typically states that the claimant must be under the care of a physician and be complying with the “approved” treatment plan. Medical marijuana is typically not an “approved” treatment.

* Medical marijuana use has the potential to become an addiction that may end up being a co-morbid condition in the case of some disabilities, requiring behavioral intervention and treatment. Critics of medical marijuana would argue that many patients taking the prescription are, in fact, recreational or addicted users of the drug and, as such, should be considered as having a medical co-morbidity when analyzing the return-to-work case.

* Employees who are being slowly transitioned with part-time or light duty work — and who are on medical marijuana treatment with or without employer’s knowledge or approval — could conceivably continue medical marijuana treatment during the transition phase and this needs to be dealt with according to legal and company policy.

* Employers should examine their drug testing policy to ensure that they are appropriately covering employees returning from STD, LTD and workers’ comp leave who may have been prescribed medical marijuana, especially in situations where potential mental impairment can endanger lives and/or increases the changes of relapse for the original condition.

Reduce Your Risk with Absence Management

One thing is certain, we are only at this point seeing the tip of the iceberg with absence management and medical marijuana. The sooner employers and RTW experts get on top of it with good policy and case management, the less potential for damage.

For more information on marijuana dependence and abuse, see our topic at