Making A Successful Claim For Medical Cannabis

New Mexico is one of the few states in the country that requires Workers’ Compensation insurers to pay for medical cannabis to treat a work injury. 

This blog post addresses some basic concepts about Workers’ Compensation in New Mexico and things you should know if you are going to submit a claim for medical cannabis to your adjuster. In many cases, Workers’ Compensation insurance companies wrongfully deny claims for medical cannabis benefits. If you are interested in asserting a claim for medical cannabis benefits in connection with your New Mexico Workers’ Compensation claim, or if your claim has been denied, we strongly encourage you to contact us now to set up a free consultation to discuss the details of your claim. 

Some basic terminology: medical benefits and authorized healthcare providers

The Workers’ Compensation system can be complicated to navigate. Your fight to get benefits is going to involve becoming familiar with some legal jargon specific to the Workers’ Compensation realm.

The New Mexico Workers’ Compensation Act (“The Act”) requires that an Employer and its Workers’ Compensation insurer pay for all reasonable and necessary medical care that is causally related to your workplace injury/disease. The Act also requires that Employers and their Insurers provide medical care in a timely manner. NMSA 1978, Section 52-1-49 (Medical and related benefits; selection of healthcare provider; artificial members) (“After an injury to a worker and subject to the requirements of the Workers’ Compensation Act, and continuing as long as medical or related treatment is reasonably necessary, the employer shall, subject to the provisions of this section, provide the Worker in a timely manner reasonable and necessary health care services from a health care provider).

Workers’ Compensation medical benefits in New Mexico are for the rest of your life. 

The Act, however, imposes some restrictions on your right to access medical care for a workers’ compensation injury/disease. For example, The Act regulates the doctors that you can see for your workplace injury/disease. The Act refers to the doctors that can treat you for a work injury/disease as “authorized healthcare providers.” Check out THE BLOG post from April 26, 2021 for more information on how your authorized healthcare provider is selected.

New Mexico law requires that your workers’ compensation insurer reimburse you for medical cannabis used to treat a work injury/disease

In Vialpando v. Ben’s Auto Servs., the New Mexico Court of Appeals made clear that “the Workers’ Compensation Act authorizes reimbursement for medical marijuana.” 

In order to assert a successful claim for medical cannabis benefits here are some important steps the law requires you to take:

  1. Have your authorized healthcare provider, the person treating you for your Workers’ Compensation injury/disease, complete a New Mexico Department of Health Physicians Authorization Form prescribing your medical cannabis for the treatment of your workplace injury/disease; 
  2. Complete the New Mexico Department of Health registration process to obtain your Patient Registry Identification Card; 
  3. Keep receipts of all the medical cannabis you purchase to treat your workplace injury/disease; 
  4. Provide a copy of the Physicians Authorization Form and a copy of your Patient Registry Identification Card to your adjuster and demand that the insurer begin reimbursing you for your medical cannabis purchases; 
  5. Your workers’ compensation adjuster is most likely going to require that you submit an itemized receipt each time you seek reimbursement for medical cannabis purchases.

Note that the Workers’ Compensation Administration limits the amount of medical cannabis that you can be reimbursed for to 8-ounces of dry weight flower (or 230 units) over any ninety-day period. These limits track with the Department of Health’s current purchase limitations on medical cannabis.

If you are interested in asserting a claim for medical cannabis, or if your claim has already been denied, contact us now to set up a free consultation. 

The New Mexico Workers’ Compensation Administration, the court that adjudicates workers’ compensation claims, currently prohibits reimbursement related to the personal production of medical cannabis; even if the medical cannabis is produced pursuant to a valid Personal Production License and is used to treat your work injury/disease. 

Candelaria Law LLC is looking for injured workers who are willing to bring a case to challenge this discriminatory rule. Our law firm believes this Rule is unlawful and violates the equal protection rights of injured workers that use PPL-grown cannabis to treat their work injuries/diseases.If you are a PPL-grower who uses your personal grow of cannabis to treat a work injury/disease and are willing to challenge this rule so that workers’ compensation will reimburse you for your PPL costs, contact us.

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