When you have a work-related injury or illness, we’re here to help you recover and get back to work. This may include providing you with health-care benefits and in some cases that may include medical cannabis.
To decide if we can include medical cannabis in your benefit coverage, we will look at:
- whether you have one of the five designated work-related medical conditions in the policy.
- whether you’ve received a clinical assessment and medical cannabis treatment has been authorized by your treating health-care professional.
- if you have already tried appropriate conventional treatments for your work-related injury or illness.
See the Cannabis for Medical Purposes policy to learn more about who is covered.
Why does the WSIB have a policy on medical cannabis?
The WSIB has introduced the policy to:
- support timely and consistent decisions regarding medical cannabis,
- provide transparency about the circumstances in which entitlement to medical cannabis will be considered for a work-related injury or illness, and
- allow entitlement to medical cannabis where it is safe and proven to have a therapeutic benefit.
Who would be entitled to medical cannabis coverage under the policy?
A person with a work-related injury or illness may be entitled to medical cannabis coverage if the following criteria are met:
- they have one of the work-related medical conditions listed in the policy,
- they have previously tried conventional treatments for their condition,
- they have received a clinical assessment for medical cannabis treatment,
- the benefits of the medical cannabis treatment for the person outweigh the risks,
- their treating healthcare professional has authorized medical cannabis for them, and
- the dose and route of administration that the healthcare professional prescribes aligns to the criteria in the policy.
How was the policy developed?
To develop the policy, the WSIB conducted considerable research on medical cannabis, which included existing scientific evidence and clinical guidance on medical cannabis, the compensation structure, and the federal access to medical cannabis scheme.
How does the WSIB ensure the policy stays current?
In 2020, the WSIB engaged an independent third party to review the scientific and clinical evidence on medical cannabis to ensure the work-related medical conditions listed in the policy continue to reflect current evidence for the therapeutic use of medical cannabis.
The WSIB recognizes that the scientific and clinical landscape pertaining to medical cannabis is evolving. To ensure the policy remains current moving forward, we will continue to monitor and review the scientific and clinical evidence for the therapeutic use of medical cannabis, and has committed to regular reviews of the scientific and clinical evidence on medical cannabis.
Why does the policy consider entitlement to medical cannabis for those with neuropathic but not other forms of pain?
According to the scientific and clinical literature reviewed to date, there is consistent evidence for the therapeutic use of medical cannabis for the treatment of neuropathic pain. Such support was not found for the treatment of acute pain or other forms of chronic pain.
Will the WSIB cover the cost of equipment required for medical cannabis treatment?
If someone with entitlement to medical cannabis is approved to administer dried cannabis using a vapourizer, the WSIB will cover the reasonable cost of a Health Canada-approved vapourizer. Pre-approval from the WSIB must be obtained before purchasing a vapourizer.
What information does the WSIB require on the “medical document” supporting the use of medical cannabis?
To allow entitlement to medical cannabis, the medical document must satisfy the requirements of the federal Cannabis Regulations and also include the following additional information, which must comply with the dosing and route of administration criteria in the policy:
- milligrams (mg) of THC per day approved for the person, and
- route(s) of administration, which cannot involve smoking.
Why does the WSIB require more information than Health Canada on the “medical document” supporting the use of medical cannabis?
The WSIB requires that the medical document be treated like the prescription for any other drug. This is consistent with the position of the College of Physicians and Surgeons of Ontario that the medical document is equivalent to a prescription.
A drug prescription includes information about the quantity, strength and direction for use of the drug being prescribed. The WSIB requires similar information on a medical document, including the mg of THC per day and the route of administration. This information supports safety and clarity around the dosing of the medical cannabis.
The federal Cannabis Regulations specify the minimum information needed to legally access medical cannabis in Canada. They do not limit the inclusion of additional information on the medical document. The federal cannabis regime regulates access to medical cannabis. It does not touch upon the circumstances in which medical cannabis may be necessary, appropriate, or sufficient health care for a person.
Decision-making authority regarding the necessity, appropriateness, and sufficiency of health care for a work-related injury or illness falls solely to the WSIB under the Workplace Safety and Insurance Act, 1997 (WSIA) and the WSIB takes its legislative responsibility seriously. As part of that authority, the WSIB can require information to support entitlement to medical cannabis, which it has done in the policy.
The policy generally limits entitlement to 30 mg THC per day and in no case, other than palliative care, can the mg THC per day exceed 75 mg. When will the WSIB consider a request for up to 75 mg THC per day?
In certain cases, there may be a need for flexibility in dosage as some medical cannabis products may be combined and variability in bioavailability may also require some consideration. In those cases requesting more than 30 mg THC per day, detailed medical rationale that includes pain and function assessments must be provided to consider such dosage.
How are you reimbursed for obtaining medical cannabis?
People who are entitled to medical cannabis will have access through the WSIB’s contracted provider. The provider will supply the medical cannabis directly to the person, according to their entitlement parameters and there will be no need for the person to pay out-of-pocket.
Why does the WSIB require both initial and follow-up cannabis assessment forms?
Initial and follow-up clinical assessments for medical cannabis treatment provide the information needed to determine whether medical cannabis is, or continues to be, necessary, appropriate, and sufficient treatment as required by the WSIA. The WSIB collects this information using the initial and follow-up cannabis assessment forms, including information about:
- the condition for which medical cannabis is being prescribed,
- any contraindications or precautions,
- any applicable risk screening tools and/or pain and function assessments completed,
- the conventional treatments the person has tried for the condition, and
- the person’s response to the medical cannabis treatment.
As with any type of health care treatment for a work-related injury or illness, the WSIB reviews the effectiveness of the treatment on an ongoing basis and, where it cannot be supported medically, the WSIB may determine it is no longer necessary or appropriate.
We compensate health care professionals for completing both the initial and follow-up forms.
What types of medical cannabis does the WSIB generally cover?
If entitlement to medical cannabis is granted, the following types of cannabis products are available in the WSIB’s Cannabis Formulary:
- Dried cannabis for use with a vapourizer
- Bottled oil with a syringe or graduated measuring device
- Soft gel capsules