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Heacox Hartman


Employers and Insurers in Minnesota are currently not legally required, under Minnesota Workers’ Compensation law, to reimburse employees for medical cannabis treatment based on the recent decision from the MN Supreme Court summarized below.

On October 13, 2021, the Minnesota Supreme Court issued two major decisions regarding medical cannabis. See Musta v. Mendota Heights Dental Center, A20-1551 (Minn. Oct. 13, 2021) and Bierbach v. Digger’s Polaris, A20-1525 (Minn. Oct. 13, 2021). The Court treated the two decisions as companion cases, and the majority of the analysis is contained in the Musta case.

The Minnesota Supreme Court made two major rulings regarding medical cannabis. First, it held that the Workers’ Compensation Courts, including the Workers’ Compensation Court of Appeals (WCCA), lack jurisdiction to decide whether federal law preempts Minnesota law requiring an employer or insurer to reimburse an employee for medical treatment in the form of medical cannabis. Second, the Minnesota Supreme Court held that the Minnesota Workers’ Compensation Act is preempted by the Federal Controlled Substance Act (CSA). As such, Employers/Insurers are not required to reimburse employees for medical cannabis used to treat a work injury.

As background, the employee in Musta worked as a dental hygienist when she suffered a work-related neck injury in February 2003. She received conservative care, underwent surgery in November 2003 and August 2006, and was ultimately prescribed medication to manage the continuing pain, including Vicodin and Fentanyl. In late 2009, the employee discontinued using narcotics to treat her pain because of the side effects. By April 2019, she began using medical cannabis in compliance with the THC Act (Minn. Stat. §§ 152.21–.37 (2020)) to treat her consistent pain. The employee then requested reimbursement for said medical cannabis from the employer, Mendota Heights Dental Center (Mendota Heights).

The employer opposed the request for reimbursement because cannabis possession is prohibited by federal law under the CSA. Cannabis is a Schedule I controlled substance, which is the most restrictive level, and cannot be lawfully prescribed under federal law. However, the Compensation Judge ruled that the employer must reimburse the employee for medical treatment, including medical cannabis. See Minn. Stat. § 176.135, subd. 1(a) (2020). The Compensation Judge declined to resolve the issue of preemption. On remand, the Compensation Judge found that the use of medical cannabis is legal under Minnesota law, and nothing in Minnesota workers’ compensation law would prohibit reimbursement for medical cannabis when used to treat a work-related injury. Therefore, the employer was required to reimburse the employee for medical cannabis expenses. The employer appealed.

The WCCA held that it lacked subject matter jurisdiction over the preemption issue and stated that it could not address whether the CSA preempts Minnesota Law as it relates to medical cannabis in workers’ compensation cases. The WCCA then affirmed the Compensation Judge’s decision, requiring the employer to reimburse the employee for medical cannabis expenses. The employer appealed the WCCA’s decision to the Minnesota Supreme Court.

The Minnesota Supreme Court held that: (1) the WCCA lacks jurisdiction to decide whether federal law preempts Minnesota law that requires an employer to provide medical treatment when the treatment sought is medical cannabis; and (2) because it is impossible to comply with both state and federal law, the Workers’ Compensation Court orders are preempted by the CSA. In a footnote, the Minnesota Supreme Court noted that its decision was limited to “a claim for reimbursement of medical expenses, incurred to treat a work-related injury, where the treatment for which the expense is incurred is the purchase and use of medical cannabis, with the reimbursement liability determined in a legal proceeding.” They expressed “no opinion on whether the CSA preempts any component of Minnesota’s medical cannabis program, nor does our preemption decision here extend to any other form of medical treatment."

Summary by Attorney Andrew Carballo