Cannabis 2018: The Decisions, Laws and Attitudes That Will Shape the Future of Workers’ Comp

From medical to recreational, marijuana laws are changing across the board. Here’s a look back on some 2018 cannabis decisions and facts and what they could mean for workers’ comp.
By: | November 29, 2018 • 4 min read

The 2013 Cole memo was created to balance out legalized recreational marijuana use on the state level with the prosecution of the substance on the federal level, where it still remains illegal. Essentially, it enabled states to enact their own laws on marijuana legalization.


And despite the Obama-era Cole memo being rescinded by the Trump administration in January of this year, marijuana legalization is still on an upward tick, with the majority of U.S. states currently allowing for medical marijuana and cannabis programs.

2018 further showed more states are looking to follow suit — just last month during the U.S.-midterm elections, Michigan, Missouri and Utah all took the next step forward in marijuana legalization.

“What we’re seeing is a popular surge in growing acceptance of marijuana in that it’s more mainstream,” said Marcos Iglesias, senior vice president and chief medical officer, Broadspire, and one of this year’s National Workers’ Compensation & Disability Conference® speakers.

Iglesias explained that as medical marijuana becomes legal, there’s an increase in the push to use it to treat work-related injuries. It seems claims professionals are asking ‘Shouldn’t we at least try it?’ he said.

On the Federal Level, Still Schedule One

Societal acceptance of the drug is at an all-time high — a Pew Research report released in October showed 62 percent of Americans support marijuana legalization, up from 61 percent in 2017. The majority of respondents’ credit medical use as a driving factor.

However, Iglesias cautioned, research into the medical benefits of marijuana should not yet be considered complete: “In my own experience in the last year, I’ve seen some seasoned claims professionals open to the idea [of medical marijuana use in workers’ comp,] but they’re uninformed on the science behind it.

Marcos Iglesias, senior vice president and chief medical officer, Broadspire

“Research into the medical effects of any drug is going to take a long time. With marijuana, it’s something that’s been illegal for so long and it’s been hard to research [because of its illegality].”

Because of this, Iglesias said, we might not have a complete understanding of medical marijuana benefits or side effects for a few more years.

This is also why marijuana remains a Schedule One substance on the federal level — there is little scientifically proven medicinal benefit and there is still a potential for drug abuse.

But that doesn’t change the fact that more states have taken an interest in the possible benefits associated with the drug — particularly when looking at the opioid crisis.

For example, New York’s State Department of Health issued an emergency regulation in July allowing for registered practitioners to certify patients for medical marijuana use as a replacement for opioids. Pennsylvania, which saw the second highest decrease in opioid prescriptions nationally (down 14 percent), has also started looking into the benefits of replacing opiates with medical marijuana.

The Recreational Wrench

The big workers’ comp issue stems from the legalization of recreational marijuana. As opioid use decreases, there has been an upward swing in positive marijuana testing in the workplace, said one Quest Diagnostic report.


This is worrisome for employees in safety-sensitive positions, like pilots; rail, bus and truck drivers; and workers in nuclear power plants, for whom routine drug testing is required by the Department of Transportation. The report showed marijuana use at such worksites increased by 8 percent from 2013 to 2017.

As of November, 10 states have legalized recreational marijuana. The midterm election showed Michigan voting to legalize recreational cannabis for those over the age of 21, paving the way for the state to become number 11.

And one of the most significant cannabis laws that went into effect this year was Canada’s nationwide legalization of recreational marijuana, which has led many to wonder if the U.S. will follow suit.

If it does, how can employers maintain a drug-free workplace policy and keep their employees safe?

Lisa Anne Bickford, director, workers’ compensation government relations, Coventry Health Care

“There’s been an ongoing debate about whether marijuana should be viewed as a recreational substance of fun … or whether it’s actually regarded as a medicine with serious medicinal benefits,” said Lisa Anne Bickford, director, workers’ compensation government relations, Coventry Health Care, in a webinar titled “The Growing Federal and State Challenges of Medical Marijuana.”

“There is some debate as to whether the growing acceptance of marijuana as a recreational substance therefore undermines the argument that it should be perceived as medicine,” she said.

For a long time, the workers’ comp cannabis debate has been focused on medical marijuana. But now, as more states consider recreational marijuana, it could mean attitudes might be changing again in the workers’ comp space. &

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]