Most injured workers have no idea this is available to them.
In New York, medical marijuana can be prescribed for a work-related injury and paid for through workers’ compensation. Not as some novel argument somebody has to invent for your case — the Workers’ Compensation Board has a route for requesting it, a standard for approving it, and a mechanism for paying for it.
People are often surprised by that, and there is a reason they are.
Your health insurance will not cover it. Comp is different.
Anyone who has looked into medical cannabis has run into the same wall: insurance does not pay. That is not an accident. Public Health Law § 3368(2) expressly relieves health insurers of any obligation to cover it.
But that exemption is written for health insurers, and workers’ compensation is not health insurance — it is basic insurance, a different animal in the statutory scheme. The exemption does not reach it.
Which is why the answer you got from your health plan tells you nothing about the answer you will get from a comp carrier.
It is a recognized treatment in the comp system
The Board’s position is that medical marijuana may be prescribed to treat conditions or sites of injury covered by the Medical Treatment Guidelines, where the treating provider establishes that it is medically necessary and that treatment under the Guidelines is not appropriate or sufficient.
Certification on the medical side has also gotten easier in New York. The State no longer works from a rigid list of qualifying conditions; a patient can be certified for any condition the provider deems suitable. Chronic pain from a work injury is squarely within what providers certify for.
New York’s courts have backed this up. In Matter of Quigley v. Village of East Aurora (2021), the Appellate Division upheld an order requiring a workers’ compensation carrier to reimburse an injured police officer for medical marijuana his pain specialist had certified. The court rejected the argument that federal drug law prevents it, because the carrier only reimburses the worker’s costs and does not buy or distribute the drug. It also held that the Public Health Law provision saying insurers do not have to cover medical marijuana does not apply to workers’ compensation.
Why this matters if you are on opioids
This is the situation where it comes up most.
You have had the surgeries. The pain did not fully resolve. You are on opioids, and they are either not controlling it or controlling it at a cost — you cannot drive, you cannot think clearly, you cannot hold down the modified duty your employer gave you. Plenty of people in that position want off the opioids and do not know there is a covered alternative to ask about.
Whether it is right for you is a medical question for your treating doctor. Whether comp can pay for it is the question this page answers, and the answer is yes.
Your doctor has to be the right kind of doctor
This is the practical obstacle people hit first, and it is worth checking before you get your hopes up. The provider needs two separate credentials:
- Registration with the State program — which requires completing an approved course of a few hours and registering as a certifying provider.
- Authorization by the Workers’ Compensation Board under WCL § 13-b, which is what lets them treat comp patients at all.
Physicians can hold both. So can nurse practitioners — NPs have been able to obtain Board authorization since January 1, 2020 — and physician assistants working under a supervising physician.
Plenty of excellent doctors have never registered for the State program. If yours has not, that is not a dead end, but it does mean the conversation has to happen with someone who has.
How it gets approved
Your doctor files the request through the Board’s OnBoard system as a Medication PAR — a prior authorization request. It used to run through the older variance process; the filing path moved and the Board has said the approval criteria stayed the same.
- The burden is on the treating provider, not on you. Your doctor has to establish medical necessity and explain why standard treatment is not appropriate or sufficient.
- Your attorney cannot file it and cannot see it. OnBoard is a provider system. How PARs work and where an attorney can step in is on our page about denied medical treatment and the variance process.
What a strong request contains
- A medical opinion explaining why this care is medically necessary for you.
- Why standard Guidelines treatment is not enough — what was tried, what it achieved, what it did not.
- Objective measures of function, not just pain scores. Range of motion, measured findings, specific changes in what you can do day to day.
- A copy of your State certification.
- The risk picture addressed head-on, including drug testing where there is any history the carrier could point to.
The functional documentation is the piece most often thin. A request built on “the patient reports significant pain” is weaker than one showing what the patient could not do in March and can do in June.
Expect a trial, not an open-ended approval
Approvals in this area tend to come in increments — a couple of months first, then a longer stretch — with continuation depending on objective evidence that it is working and that your function has improved.
So the documentation does not stop mattering once you are approved. Keep your follow-up appointments, and make sure your doctor is recording what changed, in measurable terms, while you are on it.
Why the money comes back to you instead of going to the dispensary
This is the part that catches people out even after approval, and the reason for it is worth understanding.
Marijuana is still a controlled substance under federal law. Because of that, as the Board puts it, carriers cannot implicate the federal banking system when paying for it. A comp carrier sending funds to a licensed New York dispensary would be routing money through federally regulated banking channels for a federally controlled substance — and no carrier is going to do that.
So the Board built the payment around you instead. You pay the dispensary; the carrier reimburses you. It runs as a medical and travel reimbursement under WCL § 13(a), which obliges the employer to pay for medical treatment and “other attendance and treatment” the injury requires. The carrier never transacts with the dispensary at all — it pays its own claimant, which is something carriers do every day.
Two consequences for you. Keep every receipt — a reimbursement claim with no paperwork is not a claim. And budget for the gap, because the money leaves your pocket before it comes back.
The one rule that decides more of these than any other
Approval first. Purchase second.
Care that varies from the Guidelines has to be requested and approved before it is provided, and a request will not be considered where the treatment has already been given. In Matter of Flatbed Express — a published Board decision, not a case from this office — a doctor prescribed medical marijuana in April and filed the request in July. Those intervening months became the claimant’s own expense, separate from anything about whether the treatment was justified.
That is an avoidable loss, and only avoidable beforehand. Request, then approval, then the dispensary.
While you are using it
Getting medical marijuana approved is one question. Living with it while you have a comp claim, and maybe while you go back to work, raises a few more:
- It has to be medical. Only cannabis certified by a registered practitioner for a qualifying condition can be covered. Adult-use cannabis you buy on your own is not reimbursed, even if it helps the same pain.
- You have the same protections as with other prescriptions. New York’s 2021 cannabis law gives certified patients the same rights as injured workers taking other prescribed medications that may affect what duties they can do.
- Impairment at work is still impairment. Your employer can act if you are impaired on the job, and an injury caused solely by intoxication is not covered. See intoxication and your workers’ comp claim.
- Federally regulated jobs are different. Commercial drivers and other workers covered by federal Department of Transportation drug testing follow federal rules, which do not recognize medical marijuana. Talk to us before you start if you hold a CDL or a similar safety-sensitive job.
- Keep every receipt, along with your certification and the approval.
Frequently Asked Questions
Does workers’ comp pay for medical marijuana in New York?
It can. New York courts have upheld orders requiring workers’ compensation carriers to reimburse injured workers for certified medical marijuana, but the treatment has to be requested and approved first, and the carrier typically reimburses you rather than paying the dispensary.
Do I need approval before buying medical marijuana for my work injury?
Yes. Medical marijuana is not part of the standard treatment guidelines, so your doctor has to request approval before you start. Costs from before the request is made are usually not reimbursed.
Is recreational cannabis covered by workers’ comp?
No. Only medical cannabis certified by a registered practitioner for a qualifying condition can be covered. Adult-use cannabis bought for personal use is not reimbursed.
Can my employer fire me for using medical marijuana?
New York law gives certified medical cannabis patients the same protections as workers using other prescribed medications, but employers can still act on impairment at work, and federally regulated jobs, such as commercial drivers, follow federal drug-testing rules.
Will the carrier pay the dispensary directly?
Usually not. In New York the carrier’s obligation is generally to reimburse you for approved purchases, so keep every receipt.
Talk to a New York workers’ compensation attorney
If you are managing chronic pain from a work injury and nobody has raised medical marijuana with you, it is a reasonable thing to ask your treating doctor about — and a reasonable thing to ask us about, because getting it covered is a workers’ compensation question as much as a medical one.
The Law Offices of Frank J. Dito, Jr. handles workers’ compensation claims from the office on Staten Island, for injured workers throughout the five boroughs and across New York State.
Call 718.701.2776 or 800.310.5520. The consultation is free, and you will speak with me. If we don’t recover money for you, we don’t get paid.
Nothing on this page is legal or medical advice about your own claim. Whether medical marijuana is appropriate for you is for your treating physician, and whether a particular request is approved is decided on the record put before the Board. Board procedures and State cannabis rules both continue to change.
