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Marijuana ruled 'reasonable and necessary' for injured worker's pain relief

Posted On: Jun. 30, 2015 12:00 AM CST

The New Mexico Court of Appeals has again ruled that medical marijuana should be classified as “reasonable and necessary medical care” for an injured worker.

Sandra Lewis injured her lower back on the job in December 1998, court records show. She underwent several surgical procedures and took “numerous” drugs, but continued to suffer from chronic pain.

American General Media and third-party administrator Gallagher Bassett Services Inc. requested an independent medical examination in April 2012, as Ms. Lewis had been using medical marijuana and taking prescription pain medication, according to records.

The psychologist appointed by the workers compensation judge said medical marijuana was a “reasonable and appropriate” treatment for Ms. Lewis, records show.

Ms. Lewis' authorized health care provider also said the “benefits of medical marijuana outweigh the risk of hyper doses of narcotic medications,” according to records.

In August 2013, the workers comp judge concluded that Ms. Lewis' use of medical marijuana constituted “reasonable and necessary medical care,” records show. American General Media and Gallagher Bassett were ordered to reimburse her for the receipts she submitted, leading them to appeal.

A three-judge panel of the New Mexico Court of Appeals on Friday unanimously affirmed the decision of the workers comp judge, ruling that Ms. Lewis' medical marijuana should be classified as “reasonable and necessary medical care that required reimbursement.”

According to the ruling, there is no regulatory connection between the state's Workers' Compensation Act and the Lynn and Erin Compassionate Use Act, which allows patients with debilitating medical conditions to use medical marijuana.

“Although the Department of Health requires that a person obtain two written certifications in order to be enrolled in the (Compassionate Use Act) and receive medical marijuana for severe chronic pain, the Workers' Compensation Act has no such quantitative requirements for a (workers comp judge) to determine that medical care is reasonable and necessary,” records show.

Similarly, in Miguel Maez v. Riley Industrial and Chartis, a three-judge panel of the New Mexico Court of Appeals unanimously ruled on Jan. 13 that the Compassionate Use Act allows Mr. Maez's medical marijuana authorization to be treated as a prescription for workers comp.

And in Vialpando v. Ben's Automotive Services, a three-judge panel of the New Mexico Court of Appeals unanimously ruled, in May 2014 that an employer and insurer must reimburse an injured worker for medical marijuana pursuant to the Compassionate Use Act.