Federal law bars cannabis as treatment for injured worker

March 6, 2026

Cannabis can’t qualify as reasonable and necessary medical treatment under the Longshore Harbor and Workers’ Compensation Act because it remains a Schedule I drug under federal law, the U.S. 2nd Circuit Court of Appeals ruled Thursday.

Growing acceptance of cannabis having some medicinal value — and an apparent willingness of the federal government to entertain rescheduling — are irrelevant in Luis Peña Garcia’s request for reimbursement for edibles recommended to treat chronic pain, according to Luis Peña Garcia v. Director of the Office of Workers’ Compensation Programs et al.

All that matters is that Schedule I drugs have no accepted medical use under the federal Controlled Substances Act, the court ruled, writing that “(f)ederal law thus categorically bars marijuana from being deemed a reasonable and necessary medical expense for the purposes of the LHWCA.”

Mr. Peña Garcia is permanently and totally disabled after injuring his neck, back and upper and lower extremities in May 1994. The Department of Labor in 1998 ordered his former employer, Calzadilla Construction Corp., and its insurer, IMS Insurance Co. of Puerto Rico, to provide medical care and treatment pursuant to the Longshore Harbor Workers’ Compensation Act.

In 2019, a doctor treating Mr. Peña Garcia said he responded well to edibles and that they were one of the few treatments that worked well to manage his pain at night.

Later that year, Mr. Peña Garcia asked IMS to reimburse him for payments made for cannabis-infused edibles.

The insurer denied the request, and the Department of Labor’s Office of Administrative Law Judges held that cannabis is a Schedule I drug that has no accepted medical use and cannot be a reasonable and necessary medical treatment.

The department’s Benefits Review Board affirmed.

On appeal, the 2nd COA said Mr. Peña Garcia’s argument that medical cannabis is a reasonable and necessary treatment for his pain is foreclosed by the plain text of the Controlled Substances Act, which says Schedule I substances, including cannabis, have no currently accepted medical use.

The appellate court noted that the U.S. Supreme Court in Gonzales v. Raich similarly held that the effect of the federal scheduling of cannabis shows that there are currently no accepted medical uses.

The court was not persuaded that the references in congressional riders to “medical marijuana” require a different decision because the riders don’t address whether the drug is a reasonable and necessary medical expense for federal workers’ compensation programs.

Whether some states allow cannabis to be used for medical purposes is irrelevant to questions about federal law, the court said. Similarly, whether reimbursement for cannabis would violate the prohibition on possession or distribution is also immaterial.

The fact that Congress has allowed research into medical uses of cannabis demonstrates only a willingness to explore whether medical value exists and does not denote a congressional finding that the drug has legitimate medical uses.

And, while President Donald Trump in December signed an executive order directing the attorney general to take steps to move cannabis to Schedule III, the drug remains a Schedule I substance today.

“It may very well be the case that the federal government will at some point — perhaps even in the near future — remove marijuana from Schedule I of the CSA,” the court said. “But that is a decision for the political branches of the federal government, not for the judiciary. This court is obliged to apply the law as it currently stands.”