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New Practice Directive – Cannabis for Medical Purposes

The following key changes have been made since the prior version: 

  • In the “Reasonably necessary to alleviate the effects of the injury” section, reinforcing that: 
  • the test to apply is whether it is at least as likely as not that cannabis is reasonably necessary to alleviate the effects of the compensable condition. 
  • the worker’s own statements regarding the use of cannabis on their functioning is one of the considerations for determining whether cannabis is reasonably necessary to alleviate the effects of the compensable condition. 
  • the chemical components of the cannabis product being adjudicated (i.e., amount and percentages of THC and/or CBD) is also a consideration. 
  • In the “Other considerations” section, clarifying that cannabis should not be authorized for reimbursement unless the medical evidence confirms that the worker has tried other conventional treatments and therapies. This may include a trial of pharmaceutically-produced cannabinoids. The wording changes remove the mandatory requirement to try pharmaceutically-produced cannabinoids before approving coverage for cannabis, which may be viewed as fettering an officer’s discretion or may not be appropriate clinically.