Medicinal cannabis keeps worker away from opioids

This article has been reproduced with permission from OHS Alert, and the original version appears at www.ohsalert.com.au


An injured worker has proved that medicinal cannabis is a reasonable treatment his employer should pay for, even though it has not improved his functionality.


The medical evidence in the case included differing views on how effective cannabis oil treatment was for the worker, and whether it should be used, NSW Personal Injury Commission Member Jill Toohey noted.


But there was no dispute that it significantly reduced the severe pain caused by his work injury, and allowed him to stop taking "high-risk medications" like addictive opioids, she found.


The worker was injured lifting a 100kg bed while working as a maintenance officer for Leading Edge Maintenance Services in 2017.


The employer accepted liability for his lumbar spine injury, and agree to refer him to have his whole person impairment assessed to pursue lump sum compensation, but refused to pay for his cannabis oil treatment.


In the PIC, the worker argued cannabis oil was a reasonable medical treatment under section 60 of the NSW Workers Compensation Act 1987.


He told the Commission his work injury caused him increasingly debilitating pain for which he was admitted to hospital some 15 times.


He had been using cannabis oil since a 2019 trial prompted by his doctors' concerns over his increasing use of opioids, he said. The treatment provided significant relief and allowed him to stop taking opioid medication, but self-funding the treatment came at a "huge financial burden", at $1,500 per month, he contended.


The worker argued the employer's objection to cannabis oil as a treatment was not in keeping with modern medicine.


The use of cannabis oil was now well recognised as a reasonable medical treatment by the Commission, he argued, citing the recent PIC presidential decision, Couch v Electus Distribution Pty Limited [2023] NSWPICPD 8 (see related article).


In Couch, President Judge Gerard Phillips quashed a decision denying a worker an entitlement to medicinal cannabis for chronic pain from a work injury. He affirmed that the criteria for determining claims for reasonably necessary treatment, from Diab v NRMA Ltd [2014] NSWWCCPD 72, were:


  • the appropriateness of the treatment;
  • the availability of alternative treatment and its potential effectiveness;
  • the cost of the treatment;
  • the actual or potential effectiveness of the treatment; and
  • the acceptance by medical experts of the treatment as being appropriate and likely to be effective.


The President Judge noted that this was not a "confined list of matters" that claimants needed to establish, and each case must be determined on its own facts.


In the case at hand, Leading Edge told the PIC the worker's medical reports raised questions over whether the cannabis oil treatment was helping him, showing he was sleeping up to 16 hours a day and his physical presentation was "bizarre".


The worker did not appear interested in pursuing alternative treatments, instead moving onto an addictive option that decreased his pain but did not improve his functionality, it argued.


Leading Edge's pain medicine specialist reported that the worker was advised to consult a pain management team and undertake exercise programs, but opted to go with medicinal cannabis treatment over a prolonged 18-month "trial", which was not medically appropriate and resulted in his function deteriorating.


Member Toohey agreed the evidence showed the worker's functioning had not been improved by medicinal cannabis.


But the pain medicine specialist was wrong to conclude the treatment had not benefited him, given his pain was reduced to a point where he was able to wean himself off highly addictive opioid medication, she said.


The fact that the treatment had not improved the worker's functioning was not a determinative factor of its effectiveness under the Diab criteria.


"There are difficulties with [the worker's] evidence," Member Toohey acknowledged. "There are differing views about how effective treatment with cannabis oil is and whether it should be used at all, and he has only undertaken some of the forms of alternative treatment that have been recommended," she said.



However, there was enough evidence to find that cannabis oil was a reasonably necessary treatment for his work injury, after considering the criteria from Diab, she found.


Contact Us

Zenergy News

16 May, 2024
Pete Zmuda- West Gate Tunnel Project
15 May, 2024
Zenergy were proud to host 150 clients at the 2024 Zenergy Leaders forum in Sydney CBD last Thursday. Over breakfast on a wet Thursday morning, the attendees made up of industry leaders and executives, discussed how organisations are identifying, preventing and managing psychological risks, and what best practice looks like in a practical sense. The panel were excellent and we would like to thank them for their contribution. Deloitte Australia's chief human resources officer, Tina McCreery told Zenergy Group's leaders forum in Sydney yesterday that her "big four" accounting firm's new interventions target the risks associated with the way its workers work on both organisational and individual levels, but the strategies for the latter have the greatest impact. She said Deloitte started identifying the psychosocial "hotspots" in its business two years ago, "getting underneath" the day-to-day issues impacting on workers' psychosocial wellbeing. The firm is part of an industry that has been under the spotlight for its culture of overwork, including through an independent review that heard many EY Oceania workers were subjected to "insane pressure" and unreasonable project deadlines (see related article ). McCreery told the forum that at the organisational level, Deloitte carried out engagement surveys, trained partners on mental health and engaged the executive board on these issues. However, the protective measures the company implemented on the ground level, to manage the time workers spend on projects for clients, really made a difference, she said. Deloitte introduced a range of interventions, including steps to determine at the start of an engagement what the project will look like in terms of flexibility needs, hours of work and contact hours, she explained. It leveraged technology to solve some of the issues around the risks, including bots that can identify unreasonable hours and alert workers' "coaches" to step in and check in with an overworking individual "and see what is going on". Other initiatives like "coaching conversations" mean workers are regularly asked how their work is impacting on their wellbeing, and any red flags are "routed to people to step in", McCreery said. The "big shift" resulting from the intervention is that workers now feel comfortable raising psychosocial issues and are aware of all the escalation paths, so they are "putting their hands up much more" when they are not coping. Fellow panellist Louisa Hudson, safety, security and wellbeing executive at Telstra, said companies can strike a good balance between individual and organisational level approaches. She used organisational change as an example of a psychosocial hazard. Organisational measures for this hazard include risk assessing and designing the change, taking into account all the factors that are likely to cause workers harm if it is not managed well, she said. This could include the design of the change, the timeframe, and how the company will communicate with workers. "Then you come down to that individual level and say... How will that change be felt at a local level?" Hudson said. Companies need to consider how to ensure they understand what the vulnerabilities on the individual worker level will be to the change, in terms of things like workload, introduction of new processes, and introduction of new technology, she said. They need to consider what to put in place to mitigate those risks. Further, companies need to ensure they are educating and building the capacity of the workforce to understand the basics of psychosocial risk. David Burroughs, Director at Australian Psychological Services, told the forum that 95 per cent of workers' psychosocial issues can be managed by with good leaders if they can identify the risks involved in the matter, whether they involve things like role clarity, reward and recognition, or role conflict. "The space can be overcomplicated," he said. If companies have leaders who understand what good work looks like, how their behaviour influences people's experience of working, and how to have a conversation around the actual work, they can solve most of the issues at that "localised level", Burroughs said.
22 Apr, 2024
The annual Zenergy Leaders Forum is one of the premier events on the senior health, safety & sustainability calendar in Australia.  This is a non-ticketed invitation only event hosted by Zenergy. Attendee numbers at the Zenergy forum are 150 and will include executive, people and culture directors, CEO, COO and directors of health & safety and HSE personnel. The topic for this year is “Integrated Psychosocial Risk Management”. All of the event information is below and reach out to your account manager at Zenergy for further details.
22 Apr, 2024
This article has been reproduced with permission from OHS Alert, and the original version appears at www.ohsalert.com.au . A commission has cautioned that society's "significantly raised" bar for what constitutes consent for physical interactions is "even higher" in work-related environments, in upholding the summary dismissal of a worker for inappropriately touching a colleague. In Perth, Fair Work Commission Deputy President Melanie Binet said that regardless of the intention of the worker, who claimed he was simply moving his female colleague "out of the way", his conduct was a valid reason for dismissal. Workers should be "on notice" of the increased scrutiny of behaviours, given the extensive social discourse and media coverage on sexual harassment issues, she said. "This is particularly so in the mining industry in Western Australia where a parliamentary inquiry [see related article ] focused community attention on the odious frequency of sexual harassment and assault of women in the mining industry." The Deputy President added that recent amendments to the Commonwealth Fair Work Act 2009 that specifically identify sexual harassment as a valid reason for dismissal (see related article ) "reflect a societal recognition that sexual harassment has no place in the workplace in the same way as violence or theft don't". The worker was an Alcoa of Australia Ltd advanced mechanical tradesperson when he was sacked for inappropriately touching the colleague in an office at Alcoa's Pinjarra Alumina Refinery in September last year. The worker claimed he turned his back to the colleague to squeeze between her and a desk to go to speak to another person and his hands made contact with her lower torso. Afterwards, the colleague's partner entered the office and found her visibly distressed. He confronted the worker, accusing him of grabbing the colleague's buttocks and squeezing it. The issue was escalated, and the worker was summarily dismissed after an investigation concluded he sexually harassed the colleague by making "unwelcomed and socially inappropriate physical contact". Alcoa found the worker breached codes and policies that he had been trained on, which stated that harassment was not determined by the intent of the person who engaged in the conduct but by the impact on the recipient. The worker admitted touching the colleague but claimed this only occurred because the room was crowded. He said he did not intend to behave in a sexual manner and apologised to the colleague as soon as he found out she was upset. He claimed unfair dismissal and sought reinstatement in the FWC. Deputy President Binet found the worker's accounts of the incident were inconsistent, with the parts of the colleague's body that he touched changing in his various statements. She accepted the colleague's evidence that the worker groped her in an "intimate sexual location" and his conduct caused immediate and ongoing effects to her health and wellbeing. The worker could have waited until there was space for him to pass between the desks, requested the colleague to move from the gap or gently touched her arm to get her attention, the Deputy President said. "There was simply no justification for him to turn his back then have his hands at [the colleague's] buttocks level, touch her buttocks and consciously push her out of his way," she said. "I am not convinced that [his] conduct was intended to be entirely without a sexual nature," she concluded. She stressed that even if she was wrong on this point, this type of unwelcome touching could objectively be seen as being capable of making recipients feel offended, humiliated or intimidated. The Deputy President also slammed the worker's representatives for choosing "to follow a well-worn but discredited path of blaming the victim" by accusing the colleague of inviting the "accidental" contact by standing in the narrow walkway. "Women should be able to attend their workplaces without fear of being touched inappropriately," she said in dismissing the worker's case. "It is a sad inditement of the positive work that has been undertaken by employers, unions and regulatory bodies in the mining industry that young women like [the colleague] are still frightened to report incidents of harassment for fear of being ostracised."
22 Apr, 2024
An Afternoon of Fun and Fierce Competition: Our Team's Lawn Bowls Adventure
16 Apr, 2024
Empowering Women in Safety: Insights from the Zenergy Safety Ladies' Lunch
More Posts
Share by: