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medical marijuana

State by State Marijuana Laws

With the United States continuing to battle the opioid crisis and millions of adults suffering from chronic pain, many are looking toward alternative treatments. In our recent whitepaper, we discussed the possibility of using medical marijuana in place of opioids for the treatment of chronic pain. The drug remains illegal federally, but many states have taken the step to legalize marijuana in its medical form; in fact, medical marijuana is currently legal in 29 states plus the District of Columbia, and several more states have enacted limited-purpose medical marijuana laws. Additionally, eight states and the District of Columbia have legalized marijuana for recreational purposes since 2012.

As laws continue to change and regulations evolve, what do you need to know? Which states have legalized marijuana and to what extent? Which states have passed legislation denying reimbursement for medical marijuana and which have set precedent for reimbursement requirements? Scroll through our interactive map below to learn more about laws and court rulings in each state and read our whitepaper for a deep dive into the implications of medical marijuana on workers’ compensation.

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Alabama

Recreational: Not legal

Medical: limited-purpose medical marijuana is legal

THC levels must be below 3% and the marijuana must be “essentially free from plant material”

Conditions: debilitating or chronic disease/medical conditions: seizures, Cachexia or wasting syndrome, severe or chronic pain, severe nausea, severe and persistent muscle spasms, any other severe condition resistant to conventional medicine

Legislation: SB 174 “Carly’s Law” (2014) and HB 61 (2016)

Reimbursement: No precedent

Alaska

Recreational: legal

Medical: legal

Conditions: Debilitating medical conditions

Legislation: Measure 8 (1998), SB 94 (1999), Statute Title 17, Chapter 37

Reimbursement: no precedent has been set

American Samoa

Arizona

Recreational: not legal

Medical: legal

Conditions: Cancer, AIDS, other debilitating medical illnesses upon recommendation by doctor

Legislation: Prop 203 (2010)

Reimbursement: no precedent has been set

Arkansas

Recreational: not legal

Medical: legal

Conditions: ALS, Cancer, Crohn’s Disease, Glaucoma, Hepatitis C, other chronic or debilitating diseases. (View full list in legislation below.)

Legislation: Issue 6 (2016)

Reimbursement: no precedent has been set for reimbursement

California

Recreational: legal

Medical: legal

Conditions: “serious medical condition” including: AIDS, Anorexia, Arthritis, Cachexia, Cancer, Chronic Pain, Glaucoma, Migraine, Persistent muscle spasms, severe nausea, seizures, “any other chronic or persistent medical symptom”

Legislation: Prop 215 (1996) and SB 420 (2003)

Reimbursement: No precedent

Colorado

Recreational: legal

Medical: legal

Legislation: Amendment 20 (2000)

Reimbursement: state does not require insurers to reimburse for medical marijuana use

Other: drug use policies

Coats v. Dish Network (2015): Court upheld Dish Network’s decision to fire Coats for using medical marijuana outside of work because medical marijuana is illegal federally.

Connecticut

Recreational: not legal

Medical: legal

Conditions: debilitating medical conditions such as cancer, glaucoma, HIV, AIDS, Parkinson’s, MS, etc. (View full list in legislation below.)

Legislation: HB 5389 (2012)

Reimbursement: some precedent has been set for reimbursement

Petrini v. Marcus Dairy, Inc: medical marijuana is reimbursable and constitutes reasonable and necessary medical treatment (pending)

Legislation: reimbursement is covered under state’s workers’ compensation laws

Delaware

Recreational: not legal

Medical: legal

Conditions: “debilitating medical condition” – ex: cancer, HIV, AIDS, decompensated cirrhosis, PTSD (View legislation below for full list.)

Legislation: SB17 (2011)

Reimbursement: no precedent has been set for reimbursement

District Of Columbia

Recreational: legal

Medical: legal

Conditions: “seriously ill individuals” – ex: cancer, HIV, AIDS, muscle spasm, glaucoma

Legislation: Initiative 59 (1998), L18-0210 (2010)

Reimbursement: no precedent has been set for reimbursement

Federated States Of Micronesia

Florida

Recreational: Not legal

Medical: limited-purpose medical marijuana is legal

THC levels must be below .8% and CBD levels above 10% by weight

Conditions: “Debilitating medical condition as determined by a licensed Florida physician.”

Ex: cancer, epilepsy, glaucoma, HIV, AIDS, PTSD

New Legislation: Amendment 2 (2016)

Voted in by Florida in 2016

Reimbursement: Insurers not required to reimburse for medical marijuana use

Georgia

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

Oils with THC levels below 5% and at least an equal amount of CBD

Conditions: end stage cancer, ALS, severe or end-stage MS, Crohn’s disease, mitochondrial disease, severe or end-stage Parkinson’s, severe or end-stage sickle cell disease

Legislation: HB1 (2015)

Reimbursement: no precedent has been set for reimbursement

Guam

Hawaii

Recreational: not legal

Medical: legal

Conditions: chronic or debilitating disease – ex: Cachexia or wasting syndrome, severe pain, nausea, seizures, muscle spasms, PTSD

Legislation: SB 862 (2000)

Reimbursement: no precedent has been set for reimbursement

Idaho

Recreational: not legal

Medical: not legal

Legislation: SB 1146 was vetoed by the governor in 2015

Reimbursement: no precedent has been set for reimbursement

Illinois

Recreational: not legal

Medical: legal

Conditions: debilitating medical condition – ex: cancer, glaucoma, HIV, AIDS, Hepatitis C, ALS, Crohn’s disease (View legislation below for full list)

Legislation: HB1 (2013)

Reimbursement: insurers not required to reimburse for medical marijuana

Indiana

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

THC levels must be below .3% and CBD levels must be above 5%. No other controlled substances included.

Treatment-resistant epilepsy

Legislation: HB 1148 (2017)

Reimbursement: no precedent has been set for reimbursement

Iowa

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

THC levels below 3% and free from plant material

Intractable epilepsy

Legislation: SF 2360 (2014)

Reimbursement: no precedent has been set for reimbursement

Kansas

Recreational: not legal

Medical: not legal

Reimbursement: no precedent has been set for reimbursement

Kentucky

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

Only “cannabidiol”

Intractable seizures

Legislation: SB 124 (2014)

Reimbursement: no precedent has been set for reimbursement

Louisiana

Recreational: not legal

Medical: legal, but very limited

Conditions: Glaucoma, cancer, spastic quadriplegia

Legislation: SB 143 (2015)

Reimbursement: no precedent has been set for reimbursement

Maine

Recreational: legal

Medical: legal

Conditions: Debilitating and chronic medical conditions, including cancer, glaucoma, HIV, AIDS, Hepatitis C, Crohn’s disease, chronic disease or treatment that produces intractable pain. (View full list here.)

Legislation: Question 2 (1999), LD 611 (2002), Question 5 and LD975, IB 2 (2009), LD 1811 (2010), LD 1296 (2011), Maine Medical Use of Marijuana Program Rule 10-144 (effective Feb, 2018)

Reimbursement: some precedent has been set for reimbursement

Bourgoin v. Twin Rivers: Company required to reimburse for medical marijuana because it was “reasonable and necessary”

Noll v. Lepage Bakeries, Inc.: Self-insured employer had to reimburse for “reasonable and proper” use of medical marijuana by employee

Marshall Islands

Maryland

Recreational: not legal

Medical: legal

Conditions: “chronic or debilitating disease or medical condition”

Legislation: HB 702 (2003), SB 308 (2011), HB 180/SB 580 (2013), HB 1101 – Chapter 403 (2013), SB 923 (2014)

Reimbursement: no precedent has been set for reimbursement

Massachusetts

Recreational: legal

Medical: legal

Conditions: debilitating medical conditions – ex: cancer, glaucoma, HIV, ADIS, ALS (view full list here)

Legislation: Question 3 (2012), Medical Marijuana Program (2013)

Reimbursement: some precedent has been set for reimbursement

Barbuto v. Advantage Sales and Marketing, LLC (2017): Court denied Advantage’s defense that marijuana is federally illegal. Instead, Barbuto was protected under the Americans with Disabilities Act.

Michigan

Recreational: not legal

Medical: legal

Conditions: debilitating medical condition – ex: cancer, HIV, AIDS, glaucoma, ALS, Crohn’s disease (View legislation below for full list.)

Legislation: Proposal 1 (2008)

Reimbursement: insurers are not required to reimburse for medical marijuana use

Minnesota

Recreational: not legal

Medical: legal

Any form except smoked (ex: liquid, pill, vaporized)

Conditions: Cancer, severe or chronic pain, nausea, cachexia, glaucoma, HIV, AIDS, Tourette’s , ALS, Crohn’s (View legislation below for full list.)

Legislation: SF 2471, Chapter 311 (2014)

Reimbursement: Legislation – reimbursement covered under state’s workers’ compensation laws

Mississippi

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

“CBD oil” – CBD levels must be above 15%, or a dilution of resin with over 50mg CBD per milliliter with less than 0.5% THC

Debilitating epilepsy or related illness

Legislation: HB 1231 (2014)

Reimbursement: no precedent has been set for reimbursement

Missouri

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

“Hemp extracts” – THC levels must be below 0.3% and CBD levels above 5% by weight

Intractable epilepsy that has not responded to three or more other treatment options

Legislation: HB 2238 (2014)

Reimbursement: no precedent has been set for reimbursement

Montana

Recreational: not legal

Medical: legal

Conditions: cancer, glaucoma, HIV, AIDS, severe and chronic pain, intractable nausea, intractable seizure disorders (see SB 423 for full list)

Legislation: Initiative 148 (2004), SB 423 (2011), Initiative 182 (2016)

Reimbursement: insurers are not required to reimburse for medical marijuana

Nebraska

Recreational: Not legal

Medical: Not legal

Reimbursement: No precedent

Nevada

Recreational: legal

Medical: legal

Conditions: “Chronic or debilitating medical condition” – ex: cancer, glaucoma, AIDS, severe and persistent nausea, epilepsy, MS, severe pain

Legislation: Question 9 (2000), NRS 453A, NAC 453A

Reimbursement: no precedent has been set for reimbursement

New Hampshire

Recreational: not legal

Medical: legal

Conditions: chronic or terminal disease, cachexia, severe pain that has not responded to other medicines for over 3 months, severe nausea, severe vomiting, seizures, sever muscle spasms

Legislation: HB 573 (2013)

Reimbursement: no precedent has been set for reimbursement

New Jersey

Recreational: not legal

Medical: legal

Legislation: SB 119 (2009), Program Information

Reimbursement: some precedent has been set for reimbursement

Watson v. 84 Lumber: Insurance company required to reimburse

Legislation: reimbursement covered under state’s workers’ compensation laws

New Mexico

Recreational: not legal

Medical: legal

Conditions: chronic or debilitating disease that produces severe pain or muscle spasms, or a condition that “the department designates by rule as an eligible medical condition”

Legislation: SB 523 (2007), Medical Cannabis Program

Reimbursement: some precedent has been set for reimbursement

Vialpando v. Ben’s Automotive Services and Redwood Fire & Casualty: Insurers must reimburse “qualified” workers’ compensation claimants

Legislation: reimbursement covered under state’s workers’ compensation laws

Legislation: state has a rule and fee schedule for reimbursement of medical marijuana (2016) View here.

State has maximum reimbursement amount – 230 units per calendar quarter (1 unit = around 200 mg THC) and maximum dollar amount is $12.02 per unit

New York

Recreational: not legal

Medical: legal

Conditions: “serious condition”, including cancer, HIV, AIDS, ALS, Parkinson’s, MS, epilepsy (view legislation below for full list)

Legislation: A06357 (2014)

Reimbursement: qualifying injured employees can be reimbursed

North Carolina

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

“Hemp extracts” – THC levels must be below 0.9% by weight and CBD levels must be above 5% by weight

Conditions: Intractable epilepsy

Legislation: HB 1220 (2014), HB 766 (2015)

Reimbursement: no precedent has been set for reimbursement

North Dakota

Recreational: not legal

Medical: legal

Conditions: debilitating medical conditions such as cancer, HIV, AIDS, Hepatitis C, ALS, PTSD, Crohn’s, epilepsy, etc.

Legislation: Measure 5 (2016)

Reimbursement: legislation states that medical marijuana is NOT reimbursable

Northern Mariana Islands

Ohio

Recreational: not legal

Medical: legal

THC levels below 3%, Cannabidiol no more than 32 oz and free from plant material

Conditions: AIDS, Alzheimer’s, ALS, Cancer, Crohn’s, epilepsy, glaucoma, Hepatitis C, MS, chronic and severe pain (view legislation below for full list)

Legislation: HB 523 (2016)

Reimbursement: marijuana is not on the list of approved drugs for reimbursement

Oklahoma

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

THC must be less than 0.3% in liquid form

Conditions: Minors with Lennox-Gastaut Syndrome, Dravet Syndrome, or other severe epilepsy that is not adequately treatable by traditional medical therapies

Legislation: HB 2154 (2015)

Upcoming legislation SQ 788 (2015)

Reimbursement: no precedent has been set for reimbursement

Oregon

Recreational: legal

Medical: legal

Legislation: Oregon Medical Marijuana Act (1998), SB 161 (2007)

Reimbursement: insurers are not required to reimburse for medical marijuana

Palau

Pennsylvania

Recreational: not legal

Medical: legal

Conditions: “serious medical condition”, including cancer, HIV, AIDS, ALS, Parkinson’s, MS, epilepsy, severe, chronic or intractable pain (see legislation below for full list)

Legislation: SB 3 (2016)

Reimbursement: no precedent has been set for reimbursement

Puerto Rico

Rhode Island

Recreational: not legal

Medical: legal

Conditions: “debilitating medical condition”, including cancer, glaucoma, HIV, AIDS, Hepatitis C, severe or chronic pain, seizures (see legislation below for full list)

Legislation: SB 791 (2007), SB 185 (2009)

Reimbursement: no precedent has been set for reimbursement

South Carolina

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

THC levels must be below 0.9% and CBD levels over 15%

Conditions: Lennox-Gastaut Syndrome, Dravet Syndrome, or other refractory epilepsy that is not adequately treatable by traditional medical therapies

Legislation: SB 1035 (2014)

Reimbursement: no precedent has been set for reimbursement

South Dakota

Recreational: not legal

Medical: not legal

Proposed legislation may come up in 2018

Reimbursement: no precedent has been set for reimbursement

Tennessee

Recreational: not legal

Medical: limited-purpose medical marijuana is legal for clinical research study

“Cannabis Oil” – THC levels must be below 0.9%

Intractable seizures

Legislation: SB 2531 (2014), HB 197 (2015)

Reimbursement: no precedent has been set for reimbursement

Texas

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

“Low-THC cannabis” – THC levels must be below 0.5% and CBD levels above 10% by weight

Intractable epilepsy

Legislation: SB 339 (2015)

Reimbursement: no precedent has been set for reimbursement

Utah

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

“Hemp extracts” – THC levels must be below 0.3% and CBD levels above 15% by weight

Intractable epilepsy that hasn’t responded to three or more treatment options suggested by a neurologist

Legislation: HB 105 (2014)

Reimbursement: no precedent has been set for reimbursement

Vermont

Recreational: not legal

Medical: legal

Conditions: “debilitating medical condition”, including cancer, MS, HIV, AIDS, severe pain, seizures (view legislation below for full list)

Legislation: SB 76 (2004), SB 7 (2007), SB 17 (2011)

Reimbursement: insurers are not required to reimburse for medical marijuana

Virgin Islands

Virginia

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

Cannabis oils – THC levels must be below 5% and CBD or THC-A levels must be above 15%

Intractable epilepsy

Legislation: HB 1445 (2015)

Reimbursement: no precedent has been set for reimbursement

West Virginia

Recreational: not legal

Medical: legal

No whole flower and product cannot be smoked

Legislation: SB 386 (2017)

Reimbursement: no precedent has been set for reimbursement

Wisconsin

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

THC prohibited by law, CBD without ‘psychoactive effect’ is allowed, THC and CBD levels are not definedM

Seizure disorders

Legislation: AB 726 (2013 Act 267)

Reimbursement: no precedent has been set for reimbursement

Wyoming

Recreational: not legal

Medical: limited-purpose medical marijuana is legal

“Hemp extracts” – THC levels must be below 0.3% by weight and CBD levels must be above 5% by weight

Conditions: Intractable epilepsy or seizure disorders

Legislation: HB 32 (2015)

Reimbursement: no precedent has been set for reimbursement

With all of this conflicting legislation, it is easy to get overwhelmed. Understanding what laws exist in each state gives us a better idea of how to proceed with workers’ compensation claims and business in general. Overall, though most states have moved toward legalization, there is no clear concept of what “medical marijuana” is. Every state has its own interpretation of what is acceptable. Beyond that, most states have not set any precedent for what insurers must do in the face of a workers’ compensation claim involving medical marijuana. A few have made headway in this area, but often these rulings are a case-by-case basis and do not set a hardline standard for all claims. Only a handful of states have required medical marijuana to be reimbursed, which we may see a trend toward in the future.

Whatever the future holds, medical marijuana is sure to continue to be an interesting topic of discussion. Follow Mitchell ScriptAdvisor on LinkedIn and Twitter to receive more updates as the topic develops.

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