The Maryland Legislature has legalized medical marijuana for the following conditions that would be relevant to workers compensation injuries.

The medical conditions which are authorized to be treated by medical marijuana are listed in the statute:

(i)  A chronic or debilitating disease or medical condition that results in a patient being admitted into hospice or receiving palliative care; or

(ii)  A chronic or debilitating disease or medical condition or the treatment of a chronic or debilitating disease or medical condition that produces:

1. Cachexia, anorexia, or wasting syndrome;
2. Severe or chronic pain;
3. Severe nausea;
4. Seizures; or
5. Severe or persistent muscle spasms. Md. Health-General Code Ann. Section 13-3304 (d),

(3) Have the following diseases and conditions:

(b) Post traumatic stress disorder (PTSD). Code of Maryland Regulations 10.62.03.01 (B)

1. A physician may be registered as a certifying physician to treat a patient who has a condition that is:

(1) Severe;

(2) For which other medical treatments have been ineffective; and

(3) If the symptoms reasonably can be expected to be relieved by the medical use of cannabis. Code of Maryland Regulations 10.62.03.01 ( C )

The Maryland Medical marihuana statute has many safeguards in order to protect the patient, the public, and the entity paying for the service including insurance companies or government. While the Maryland Medical marihuana statute is silent on the issue of third party payments, because of the safeguards existing workers compensation law is broad enough to include such treatment or medication. A summary of the relevant Maryland Medical marihuana law follows next.

Must be 18 years of age or older to obtain on your own without a guardian (Md. Health-General Code Ann. Section 13-3301(b)

If 18 or older patient can designate a caregiver who is 21 years old or older who has agreed to assist with a qualifying patient’s medical use of medical cannabis. Code of Maryland Regulations 10.62.01.01

If under 18, then you may obtain medical marihuana but need a caregiver -parent or legal guardian who has agreed to assist with a qualifying patient’s medical use of cannabis. Md. Health-General Code Ann. Section 13-3301 (b), Code of Maryland Regulations 10.62.01.01

In order to become a caregiver, an application must be made with the Natalie M. LaPrade Medical Cannabis Commission . Upon being designated a caregiver by a qualifying patient, a caregiver shall:

(1) Apply to the Commission for an identification card; and provide An attestation that the caregiver is not the caregiver for more than five qualifying patients; Code of Maryland Regulations 10.62.06.02

Can only get this prescribed by a certifying provider which are limited to a physician, dentist, podiatrist , nurse practitioner or nurse midwife actively licensed and in good standing with their professional board and who has a State controlled dangerous substances registration and is registered with the Natalie M. LaPrade Medical Cannabis Commission to make cannabis available to patients for medical use. 13-3301(c)

Must be a Qualifying patient” means an individual who:

(1)  Has been provided with a written certification by a certifying provider in accordance with a bona fide provider-patient relationship; and

(2)  If under the age of 18 years, has a caregiver. 13-3301(m)

In addition to be a Qualifying patient” means an individual who:

(a) Lives in the State or, during that time an individual is present in the State, is physically present in the State for the purpose of receiving medical care from a medical facility in the State;

(b) Has been provided with a written certification by a certifying physician in accordance with a bona fide physician-patient relationship; and

(c) If younger than 18 years old, has a caregiver. Code of Maryland Regulations 10.62.01.01  (25)

The certifying provider (medical person) must register with the Natalie M. LaPrade Medical Cannabis Commission as a certifying provider for each patient and submit the following:

a provider shall submit a proposal to the Natalie M. LaPrade Medical Cannabis Commission that includes:

(1)  The reasons for including a patient under the care of the provider for the purposes of this subtitle, including the patient’s qualifying medical conditions;

(2)  An attestation that a standard patient evaluation will be completed, including a history, a physical examination, a review of symptoms, and other pertinent medical information; and

(3)  The provider’s plan for the ongoing assessment and follow-up care of a patient and for collecting and analyzing data. Md. Health-General Code Ann. Section 13-3301 (a) and (b) Md. Health-General Code Ann. Section 13-3304 (b),

The provider must:

(3) “Bona fide physician-patient relationship” means a treatment or counseling relationship between a physician and a patient in which the physician has:

(a) Reviewed the patient’s relevant medical records and completed an in person assessment of the patient’s medical history and current medical condition;

(b) Created and maintained records of the patient’s condition in accord with medically accepted standards; and

(c) A reasonable expectation that the physician will monitor the progress of the patient while using medical cannabis and take any medically indicated action:

(i) To provide follow-up care to the patient;

(ii) Regarding the efficacy of the use of medical cannabis as a treatment of the patient’s severe or debilitating medical condition; and

(iii) Regarding any adverse event associated with the use of medical cannabis. Code of Maryland Regulations 10.62.01.01  (3)

The conditions which are authorized to be treated by medical marihuana are listed in the statute. approve provider applications for the following medical conditions:

(i)  A chronic or debilitating disease or medical condition that results in a patient being admitted into hospice or receiving palliative care; or

(ii)  A chronic or debilitating disease or medical condition or the treatment of a chronic or debilitating disease or medical condition that produces:

1. Cachexia, anorexia, or wasting syndrome;
2. Severe or chronic pain;
3. Severe nausea;
4. Seizures; or
5. Severe or persistent muscle spasms. Md. Health-General Code Ann. Section 13-3304 (d),

(3) Have the following diseases and conditions:

(a) Glaucoma; or

(b) Post traumatic stress disorder (PTSD). Code of Maryland Regulations 10.62.03.01 (B)

1. A physician may be registered as a certifying physician to treat a patient who has a condition that is:

(1) Severe;

(2) For which other medical treatments have been ineffective; and

(3) If the symptoms reasonably can be expected to be relieved by the medical use of cannabis. Code of Maryland Regulations 10.62.03.01 ( C )

There may be other conditions that the medical provider may feel are appropriate and the procedure to get those approved is provided in the law.)  Approval for other conditions permitted.  The Natalie M. LaPrade Medical Cannabis Commission may approve applications that include any other condition that is severe and for which other medical treatments have been ineffective if the symptoms reasonably can be expected to be relieved by the medical use of cannabis. Md. Health-General Code Ann. Section 13-3304 (e),

The Natalie M. LaPrade Medical Cannabis Commission shall conduct a public hearing to evaluate any petition to consider other medical conditions, medical treatments, or diseases that may be treated by using medical cannabis and included in certifying physician applications. Code of Maryland Regulations 10.62.07.02

As part of the written certification from the certifying provider for each qualifying patient, the certifying provider must submit to the Natalie M. LaPrade Medical Cannabis Commission:

(f) Plan to assess patient outcomes, provide follow-up care, and to collect and analyze data;

(2) An attestation that the:

(a) Physician’s Maryland license to practice medicine is active, unrestricted, and in good standing;

(b) Physician is registered to prescribe controlled substances by the State; and

(c) A standard patient evaluation will be completed and include:

(i) A history;

(ii) A physical examination;

(iii) A review of symptoms; and

(iv) Any other pertinent medical information;

(3) The medical conditions for which the physician may issue written certifications for medical cannabis;

(4) The physician’s other inclusion criteria; and

(5) The reasons the physician may deny issuing a written certification of medical cannabis. Code of Maryland Regulations 10.62.03.01 (a) (2)

10.62.05.01

.01 Issuing a Written Certification.

1. A certifying physician may determine that a patient qualifies for a written certification only:

(1) If the qualifying patient has registered with the Commission;

(2) For whom the certifying physician has a bona fide physician-patient relationship;

(3) If the qualifying patient meets the certifying physician’s inclusion criteria;

(4) If the qualifying patient does not meet the certifying physician’s exclusion criteria; and

(5) If the certifying physician has determined that the potential benefits of the medical use of cannabis likely outweigh the health risks for the patient.

1. The certifying physician shall:

(1) Log onto the website of the Commission to transmit the written certification to the Commission; and

(2) If requested, provide a copy of the written certification to the qualifying patient.

1. A written certification shall include the:

(1) Physician’s name, Maryland Board of Physicians license number, and office telephone number;

(2) Qualifying patient’s name, date of birth, address, and county of residence;

(3) Medical condition requiring medical cannabis; and

(4) The date of qualification as a qualifying patient.

1. A written certification may contain, if applicable, a written statement certifying that, in the physician’s professional opinion, a 30-day supply of medical cannabis would be inadequate to meet the medical needs of the qualifying patient.
2. A certifying physician may discuss the use of medical cannabis with a patient.
3. A certifying physician shall terminate a written certification if:

(1) The qualifying patient meets the physician’s exclusion criteria;

(2) Treatment with medical cannabis is no longer necessary for the qualifying patient;

(3) Adverse effects of medical cannabis outweigh the benefits to the qualifying patient’s health; or

(4) There is evidence that the qualifying patient engaged in diversion of medical cannabis.

1. A certifying physician may terminate a written certification if the qualifying patient demonstrates abuse of any substance of abuse.
2. A certifying physician shall notify the Commission within 1 business day of the termination of a written certification.
3. A qualifying patient shall have only one certifying physician at any time. Code of Maryland Regulations 10.62.05.01

On receipt by the Natalie M. LaPrade Medical Cannabis Commission of a written certification from the certifying provider, the Natalie M. LaPrade Medical Cannabis Commission shall issue an identification card to each qualifying patient or caregiver named in the written certification. Md. Health-General Code Ann. Section 13-3302 ( d ) Md. Health-General Code Ann. Section 13-3304 (g),,

After submission by the certifying provider to the Natalie M. LaPrade Medical Cannabis Commission and receipt by the certifying provider of the written certification, the patient will receive from a certifying provider a written certification (Md. Health-General Code Ann. Section 13-3304 (g)) which is similar to a prescription that you would receive from a doctor for most regulated drugs. (n)  Written certification.  “Written certification” means a certification that:

(1)  Is issued by a certifying provider to a qualifying patient with whom the provider has a bona fide provider-patient relationship; and

(2)  Includes a written statement certifying that, in the provider’s professional opinion, after having completed an assessment of the patient’s medical history and current medical condition, the patient has a condition:

(i)  That meets the inclusion criteria and does not meet the exclusion criteria of the certifying provider’s application; and

(ii)  For which the potential benefits of the medical use of cannabis would likely outweigh the health risks for the patient; and

(3)  May include a written statement certifying that, in the provider’s professional opinion, a 30-day supply of medical cannabis would be inadequate to meet the medical needs of the qualifying patient.Under this section the provider can limit the amount the patient can obtain to a thirty day supply or can increase the amount if he feels it will be inadequate. Md. Health-General Code Ann. Section 13-3301 (n),

The law defines a 30 day supply. (35) “30-day supply” means:

(a) 120 grams of usable cannabis unless the physician determines this amount would be inadequate to meet the medical needs of the qualifying patient; or

(b) In the case of a medical cannabis-infused product, 36 grams of ?9-Tetrahydrocannabinol (THC) unless the physician determines this amount would be inadequate to meet the medical needs of the qualifying patient. Code of Maryland Regulations 10.62.01.01 (35)

A qualifying patient or caregiver may obtain medical cannabis only from a medical cannabis grower licensed by the Natalie M. LaPrade Medical Cannabis Commission  or a dispensary licensed by the Natalie M. LaPrade Medical Cannabis Commission. Md. Health-General Code Ann. Section 13-3304 (g),

The following persons acting in accordance with the provisions of this subtitle may not be subject to arrest, prosecution, or any civil or administrative penalty, including a civil penalty or disciplinary action by a professional licensing board, or be denied any right or privilege, for the medical use of cannabis:

(1)  A qualifying patient:

(i)  In possession of an amount of medical cannabis determined by the Commission to constitute a 30-day supply; or

(ii)  In possession of an amount of medical cannabis that is greater than a 30-day supply if the qualifying patient’s certifying provider stated in the written certification that a 30-day supply would be inadequate to meet the medical needs of the qualifying patient;

(3)  A certifying provider;

(4)  A caregiver;

(b)  Penalty for distributing, possessing, manufacturing, or using cannabis diverted from approved program. —

(1)  A person may not distribute, possess, manufacture, or use cannabis that has been diverted from a qualifying patient, a caregiver, a licensed grower, or a licensed dispensary.

(2)  A person who violates this subsection is guilty of a felony and on conviction is subject to imprisonment not exceeding 5 years or a fine not exceeding $ 10,000 or both.

(3)  The penalty under this subsection is in addition to any penalties that a person may be subject to for manufacture, possession, or distribution of marijuana under the Criminal Law Article. Md. Health-General Code Ann. Section 13-3313

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