Highlights of Noteworthy Decisions

Decision 1131 20
N. Perryman
  • Health care (medical aid) (marijuana)
  • Board Directives and Guidelines (health care) (cannabis)

The worker suffered a low back injury in September 2003. In Decision No. 137/06, the Tribunal found that the worker had a permanent impairment. The Board then granted the worker a 22% NEL award, later replaced by a 40% award for chronic pain disability. In Decision No. 2341/18, the Tribunal found that the worker had entitlement for schizophrenia.

The worker now appealed a decision of the Appeals Resolution Officer denying entitlement for medical cannabis after March 2019.
Board Operational Policy Manual, Document No. 17-01-10, on cannabis for medical purposes (March 1, 2019), applies to all purchases of medical cannabis made on or after March 1, 2019, for all accidents. Accordingly, the policy was applicable to this appeal.
Document No. 17-01-10 sets out criteria for entitlement to cannabis, which are different from the test set out in previous Tribunal decisions. Document No. 17-01-10 indicates that medical cannabis is not necessary, appropriate or sufficient health care treatment for most medical conditions due to the lack of strong and consistent evidence of therapeutic efficacy and due to the unknown harms that may be associated with its use. The policy does allow entitlement if seven criteria set out in the policy are met.
In this case, the worker did not meet most of the criteria.
The worker did not have a designated condition for which she has received entitlement. A designated condition refers to a number of conditions including neuropathic pain. The worker submitted that she suffered from neuropathic pain. The Vice-Chair noted that Document No. 17-01-10 defines neuropathic pain as "pain arising as a direct consequence of a demonstrable lesion or disease affecting the somatosensory system." The worker's entitlement was limited to a lumbar strain injury superimposed on degenerative disc disease. The Vice-Chair found no objective clinical evidence of any neurological disorder or neuropathy consistent with the definition in the policy.
As all criteria in the policy must be met in order to allow entitlement, this failure to meet the first criterion was sufficient. None the less, the Vice-Chair also considered the other criteria.
There was no evidence of significance to indicate that all conventional treatments were ineffective or not tolerated. It was unclear which medical practitioner was assessing the appropriateness of medical cannabis and monitoring the worker. The Vice-Chair was not directed to a clinical assessment, as defined in the policy, that contains measurable findings. In addition, for workers who suffer from neuropathic pain, a baseline functional assessment using validated measures is required. There was no evidence of significance to indicate that a baseline assessment, such as the one contemplated within the policy, was performed.
The appeal was dismissed.