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OPINION: Workers’ Compensation Should Cover CBD Oil

Continued cannabis stigma only risks fueling the opioid crisis

cbd oil and flower
CBD oil is proven to be an excellent alternative for those with chronic pain. (Adobe Stock)

With hundreds of thousands of people dead and untold numbers of families destroyed in the wake of the opioid epidemic, cannabidiol (CBD) is proven as an “excellent alternative to an opioid in chronic pain” and is completely legal — yet it’s not clear if injured workers in North Carolina can access it through their workers’ comp benefits. Even as North Carolina moves toward legalizing medical marijuana, some workers’ comp doctors in the state are hesitant to recommend or prescribe CBD to help their patients.

To help injured workers heal safely and get back to work without opioids, the North Carolina Industrial Commission must clarify that workers’ compensation insurance covers CBD when recommended by a doctor.

Otherwise, North Carolina may run the risk of a situation like what happened recently in Pennsylvania, where an injured worker’s doctor wrote a prescription for CBD oil to treat pain caused by work-related injuries. The substance relieved his pain, preventing him from having to increase his dosage of opioid-based painkillers and helping him avoid back surgery.

But his employer refused to cover the cost of the CBD, denying that it was a “medical supply” under state law. The employer also said that providing coverage would violate Federal Drug Administration (FDA) policy.

Fortunately, after a long legal battle, the Pennsylvania Commonwealth Court ruled that the CBD should have been covered after all.

According to Harvard Medical School, CBD “may prove to be a helpful, relatively non-toxic option for managing anxiety, insomnia, and chronic pain.” Another study published in the journal Pain Management Nursing found that between 42% to 66% of patients reported pain reduction from CBD use.

But without official clarification from the Industrial Commission, insurance companies dealing in workers’ compensation in North Carolina may refuse to see CBD in the same positive light. Under North Carolina law, workers’ compensation shall be provided by the employer (or insurance carrier) if the doctor believes it will provide relief or lessen the period of disability. CBD clearly meets this requirement if an injured worker’s doctor recommends it to help treat their injury.

Despite CBD’s therapeutic benefits, whether it is available to injured workers under workers’ compensation coverage in North Carolina is murky at this point. Since CBD is derived from the cannabis plant, it raises the specter and stigma surrounding marijuana – even though CBD does not produce a high like psychoactive cannabis and can be extracted from non-psychoactive hemp.

Remember, non-psychoactive, hemp-derived CBD is already fully legal to purchase and use in North Carolina, so there is no reason why a doctor shouldn’t be able to recommend it to an injured worker at their discretion.

It’s important to note that other alternative forms of medical treatment are covered by workers’ compensation in North Carolina, including Botox, aquatic therapy, chiropractic care, and gym memberships. CBD should be no different.

North Carolina is likely to follow the lead of many other states soon and legalize marijuana, at least for medical purposes. The North Carolina Compassionate Care Act (SB 3), a medical marijuana bill, is set for a vote in the House Health Committee in 2024 and if approved, would advance to the floor for a full House vote. Yet, when it comes to CBD, doctors in North Carolina may be hesitant to even prescribe or recommend it to injured workers due to the likelihood of insurance company pushback.

The North Carolina Industrial Commission can use this moment as an opportunity to clarify insurance coverage rules regarding CBD so that doctors can treat patients in the most beneficial and safest ways possible. Otherwise, physicians will be deterred from recommending an effective, non-opioid substance to injured workers that could help relieve their pain and get them back to work faster.

Daniel Lehrer is an attorney at the Charlotte-based Law Offices of James Scott Farrin and a North Carolina State Bar Board Certified Specialist in workers’ compensation law.

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