The legalization of marijuana has been one of the fastest-moving changes in U.S. law over the past decade. As of 2025, medical marijuana is legal in 38 states, including Ohio, and recreational marijuana is legal in nearly half the country. At the same time, the opioid crisis continues to affect millions of Americans, and some doctors are exploring marijuana as a safer alternative to addictive painkillers.
There are reports of injured workers successfully weaning themselves off opioids with the help of medical marijuana. Research is still in its early stages, but studies suggest cannabis may help treat chronic pain, epilepsy, glaucoma, and even some traumatic injuries.
One 2017 study published in the Journal of the International Association for the Study of Pain asked medical marijuana patients to rate its effectiveness for pain relief. On average, patients rated cannabis at 74.6 percent effective, which is significant. Still, marijuana remains a complicated issue for workers’ comp cases.
Federal Law vs. State Law
Even though many states allow medical or recreational marijuana use, cannabis is still classified as illegal under federal law. That means if a doctor prescribes medical marijuana for an injured worker, an insurance carrier may still have grounds to deny payment.
So far, only a handful of states—including Connecticut, Maine, Minnesota, New Jersey, and New Mexico—require insurers to reimburse medical marijuana in workers’ comp claims. Ohio does not require it, and courts have been inconsistent nationwide. As marijuana laws expand, the clash between state legalization and federal prohibition continues to create confusion.
Drug-Free Workplace Policies
Another major factor is how marijuana legalization interacts with drug-free workplace policies. Employers are allowed to maintain drug-free environments to reduce safety risks, but what happens when an employee has a legal medical marijuana card?
Courts across the country have taken different approaches:
- In Colorado, courts ruled that employers can enforce drug-free workplace rules and fire employees who test positive for marijuana, even if the drug is legal in the state.
- In Massachusetts, courts decided that employees with legal prescriptions may be protected from disability discrimination if they are fired solely for marijuana use.
Here in Ohio, the law gives employers broad discretion. Ohio’s workers’ compensation system creates a rebuttable presumption that if you test positive for cannabis, you were intoxicated at the time of the accident and that the intoxication caused the injury. This makes it difficult for injured workers who test positive to win a claim, even if they were not impaired while working.
The Problem with Proving Impairment
Unlike alcohol, there is no reliable test that can determine whether someone is actively impaired by marijuana at the time of an accident. Urine tests may detect cannabis weeks after use, even if the employee was completely sober at work. This makes enforcement tricky for employers and unfair for employees who may legally use marijuana during off-hours.
As the science evolves, employers, lawmakers, and courts will need to find better ways to balance safety concerns with employee rights. For now, Ohio workers who test positive face an uphill battle when filing a claim.
What This Means for Ohio Workers
If you use medical marijuana legally in Ohio and are injured on the job, your workers’ comp claim could be challenged. Insurance carriers and employers often use positive test results to deny claims. That is why having an experienced workers’ compensation attorney on your side is critical.
