The Workplace Safety and Insurance Board (WSIB) has published its official Operational Policy on Cannabis for Medical Purposes. This policy issues clear guidelines about when the WSIB will pay for medical marijuana to treat workplace injury and illness. It also helps define when and how employees may use medical cannabis in the workplace. These guidelines went into effect on March 1, 2019 and will help you manage workplace medical cannabis use fairly, consistently and legally.

If an employee is injured or falls ill, these WSIB guidelines will help you and your employees know what to expect if and when a doctor suggests medical cannabis as a treatment. The WSIB plans to review the policy again in two years, hopefully smoothing out any issues that continue to cause confusion.

The Basics

In order for medical marijuana to be an option, the WSIB requires users to meet two criteria. The first is an age limit. Employees under the age of 25 are never eligible for medical cannabis treatment. The WSIB also disallows medical marijuana for anyone who currently has or has ever had a substance abuse issue of any kind.

From alcohol abuse to pain-killer addiction, employees who have abused legal or illegal substances in the past are automatically disqualified from receiving medical marijuana from the WSIB. These employees may still have the legal right to receive medical marijuana treatment, but the WSIB won’t pay for it.

Designated Conditions

Science supports the use of medical marijuana for a variety of ailments, but the drug isn’t a panacea by any means. The WSIB specifically outlines five conditions for which the drug is an acceptable treatment. They are:

  • Neuropathy and nerve pain
  • Spasms caused by spinal cord injury
  • Nausea and vomiting resulting from chemotherapy / cancer treatment
  • Anorexia caused by AIDS or HIV
  • Pain and other issues which require palliative care

The WSIB will not provide or approve marijuana or cannabidiol (CBD) treatment for any other conditions, injuries or diseases.

Doctor Approval

Workers may not take it upon themselves to decide that medical marijuana is an appropriate or necessary treatment for their condition. The WSIB requires a qualified medical health professional to examine the person and authorize cannabis treatment. This ensures that medical marijuana is appropriate for both the condition it’s meant to treat and the individual receiving treatment.

If an employee seeks a second opinion, both doctors must approve cannabis as a treatment. This prevents your employees from finding a doctor to say “yes” to medical marijuana when the primary physician treating their condition says “no.”

Other Treatments Have Failed

Medical cannabis is a blessing for those who need it, but the drug isn’t meant as a first line of defense. As such, the WSIB requires employees to try conventional and established treatments before turning to medical marijuana. Treatment with marijuana and CBD should commence only when other treatments have failed or were poorly tolerated.

A physician must document their attempts to help an employee using traditional medical treatments before declaring them a failure. The doctor must note in the patient’s medical record which treatments were tried, and with what results. If a certain treatment proved intolerable, the doctor must note why.

The exception to this rule is palliative care. In a palliative care situation, a doctor has already established that curing a certain illness or eliminating pain is impossible and that symptom management is the only viable treatment.

Employees seeking medical cannabis for palliative care need not meet this requirement.

Assessment and Ongoing Findings

The WSIB requires a physician to approve an employee’s medical marijuana use, but this approval must also have merit. Before approving treatment, the WSIB requires employees to undergo a clinical medical assessment of their condition. The doctor performing the assessment must include measurable findings and specifics in his records, and care must continue after the initial visit.

Doctors must continue to monitor the employee and record his or her progress and document the need for ongoing treatment. The WSIB continues paying for all treatments, including medical cannabis treatment, only so long as the employee is benefiting from medical care.

Benefits Must Outweigh Risks

When undergoing any medical treatment, it’s important to weigh both the benefits and the risks. Though it’s considered a natural remedy, this statement is no less true for medical marijuana. The WSIB will approve this treatment only when it won’t interfere with other medications an employee is taking or treatments they are receiving.

As stated previously, the WSIB won’t approve medical cannabis for employees with a history of substance abuse. They may also deny those with a personal history, or strong family history, of psychosis.

How and How Much

The WSIB requires employees using medical cannabis to take the lowest effective dose possible. The daily quantity of dried medical cannabis must not exceed three grams per day while the he milligrams (mg) of THC per day should be no more than 30 mg, but in no case shall exceed 75 mg.

Get it in Writing

An employee who receives approval to use medical cannabis from his doctor and who meets the WSIB requirements isn’t quite finished yet. They must make sure to meet any legal requirements of the province in which he or she lives and works.

Employees must obtain documentation stating that a doctor approved their medical marijuana usage. This information must detail the authorized dosage amount and administration method. This document must also state how much THC the medication they’re using contains.


An employee who meets all these requirements can have the WSIB pay a reasonable fee for their medical cannabis so long as the drug treats a work-related injury.

In order to receive reimbursement, the employee must register as a client of, and purchase his or her medication from, a hospital or fully licensed medical cannabis vendor. The WSIB will not reimburse employees for marijuana purchased at a recreational dealer or grown at home.

You may also wish to remind employees that they still need to obtain WSIB approval before purchasing medical marijuana. Once they have met all the WSIB requirements, an employee must still seek prior approval from the WSIB before purchasing this medication. The WSIB will not reimburse an employee who failed to obtain authorization before purchasing medical marijuana, even if they meet the WSIB’s usage criteria.

The Bottom Line – Workplace Medical’s Perspective

The legalization of cannabis has raised specific issues around the accommodation of medical marijuana use, but more importantly, it has shed a light on broader questions related to any prescription or non-prescription drug use in the workplace.

What are the employer obligations? What policies and procedures need to be in place? What are the supervisor’s responsibilities to report suspected impairment? How do you implement and follow-up on the policies?

Drugs and alcohol in the workplace are risk management issues for employers, with impacts on health and safety, absenteeism, employee engagement, customer service and compliance.

We can help your organization by providing a strategic review of your absence management program, develop your drug and alcohol policy, and provide services to implement and manage your policy. Contact us today.