Welcome to RIMScast. Your host is Justin Smulison, Business Content Manager at RIMS, the Risk and Insurance Management Society.

In this episode, Justin interviews Kiersten Cash regarding the May 6th RISKWORLD session that she is co-presenting with Frank Wickersham, a Workers' Comp defense attorney, "Reefer Madness: Still in the Weeds with Medical Marijuana and Workers' Compensation Insurance, Legal, and Regulatory." Kiersten shares the biggest misconception risk professionals have about medical marijuana in Workers' Comp. She discusses the conversation around cannabis and workplace injury. Justin and Kiersten talk about the growing patchwork of state laws on cannabis and what risk managers should be paying close attention to right now. Kiersten explains the concerns about Workers' Comp paying for medical marijuana. She gives a preview of what to expect in her RISKWORLD session.

Listen for insights about the problems of marijuana as a treatment option in Workers' Comp.

Key Takeaways:

[:01] About RIMS and RIMScast.

[:14] Public registration is open for RISKWORLD 2026, which will be held from May 3rd through 6th in Philadelphia. Visit RIMS.org/RISKWORLD to register.

[:27] About this episode of RIMScast. Our guest is Kiersten Cash. She is the Senior Manager for Workers' Compensation and General Liability at the Children's Hospital of Philadelphia. She's going to talk to us all about medical marijuana and Workers' Compensation Claims. But first…

[:58] RIMS Virtual Workshops. The next RIMS-CRMP Exam Prep Course will be on April 21st and 22nd, and then again on June 9th and 10th. Registration links are in this episode's notes.

[1:14] On April 15th, we have a virtual workshop covering "Emerging Risks", led by Joseph Mayo. Register today and strengthen your risk knowledge. RIMS members always enjoy deep discounts on the virtual workshops.

[1:29] Webinars. On April 16th, Zurich and World Travel Protection will present "Navigating the New Global Risk Landscape: Lessons for Business Travelers in Unstable Times". Register for webinars at RIMS.org/webinars and through the links in this episode's show notes.

[1:47] Folks, for more RIMS content, head over to YouTube and subscribe to @RIMSOfficialChannel. There you will find video podcasts, RIMScast Canada video podcasts, and other informative and entertaining content from RIMS.

[2:02] Head over to RMMagazine.com for the Q1 Edition of the Azbee-Award-winning publication, RIMS Risk Management Magazine.

[2:15] On with the Show! Our guest today is the Senior Manager for Workers' Compensation and General Liability at the Children's Hospital of Philadelphia, Kiersten J. Cash. She's here to discuss what's going on with medical marijuana and Workers' Compensation claims.

[2:31] This will serve as a bit of a preview of her session at RISKWORLD on May 6th at 10:15 a.m. in Room 120-BC, "Reefer Madness: Still in the Weeds with Medical Marijuana and Workers' Compensation."

[2:43] We will discuss whether cannabis is still an effective treatment for chronic pain due to workplace injury and what could happen if the U.S. Government were to change its schedule from number 1 to number 3.

[2:54] We're going to learn about Kiersten's fascinating work and her career. Let's get to it!

[3:00] Interview! Kiersten Cash, MBA, welcome to RIMScast!

[3:23] Kiersten is with the Children's Hospital of Philadelphia, or CHOP. Kiersten Cash has a session at RISKWORLD, "Reefer Madness."

[4:27] Kiersten has been in the world of Workers' Comp for a little over 20 years. She started as an adjuster. She adjusted national market claims and middle market claims for 10 years. Then she went to the broker side.

[4:46] She managed the claim program for the broker's largest client at the time, along with 23 other claim programs, covering all lines of insurance. Next, Kiersten worked for Devereux Advanced Behavioral Health, a residential treatment facility.

[5:06] Then Kiersten moved to CHOP, where she manages all of Workers' Comp, General Liability, and Auto for the health system.

[5:22] Kiersten says Workers' Comp is one of those industries where you kind of fall into it. In the final year of her graduate program, she needed a job. She met someone who worked at Liberty Mutual, who said they were hiring claims adjusters. She took the job.

[5:44] Kiersten says she tried to get out of this industry on numerous occasions, but the industry apparently loves her too much. She's glad she stayed because she really likes where she has ultimately landed, CHOP.

[6:52] Kiersten is a member of the Delaware Valley Chapter of RIMS, the oldest RIMS chapter. RIMS is 76 years old. The chapter is 75 years old. Chapter President Tom Armstrong was on RIMScast recently, excited about all the cool things the host chapter is doing for RISKWORLD.

[7:44] Justin asks what Kiersten feels is the biggest misconception risk professionals have about medical marijuana and Workers' Compensation. She thinks the biggest misconception is that there is a difference between medical marijuana and recreational marijuana.

[8:18] Kiersten says, as an employer, we do not want a trace in our employees' system while working, whether prescribed by a doctor or not. Legalizing marijuana for medicinal use does not excuse an employee from being impaired at work.

[8:36] Kiersten thinks that, down the pike, this will cause a major conflict as this continues to be a topic of conversation. Kiersten hopes to dispel that misconception in this episode of RIMScast and in her presentation at RISKWORLD.

[9:12] Kiersten says she has not had to have this conversation at CHOP from a Workers' Comp perspective, as they have not seen an influx of chronic pain or severe injuries in her tenure. That's good from the employer's perspective, as injuries are under control.

[9:38] Kiersten says that when we get into back surgeries, shoulder surgeries, or other major surgeries, she definitely sees this conversation becoming an issue.

[9:53] Kiersten says she is very good at interacting with the medical providers involved in her program. If medical marijuana were to become a treatment option, Kiersten would need to sit down with the pain management specialist or physician to talk about it, so it is monitored.

[10:29] The goal is not to put an employee on medical marijuana and keep renewing the card so they're just out there, collecting marijuana. There has to be a treatment plan with a target date.

[10:53] The goal of Workers' Compensation is always either to get the employee back to work or to their baseline, so they can function in society as a human being.

[11:06] Kiersten has not had to deal with prescription opioid claims, thankfully. In her adjuster days, she has seen situations where opioids have been out of control. There were times when she would propose detox programs for employees who were addicted to opioids.

[11:32] It would start with something like a back surgery. The employee was still in pain, and instead of addressing the cause of the pain, they would get opioids and end up getting addicted to them to the point that weaning off the opioids was not an option.

[11:55] Talking about medicinal marijuana, could marijuana have the same effect? That's one thing we are not sure of right now.

[12:25] Justin notes that opioid addiction often leads to huge nuclear verdicts and settlements, some of which are still being litigated.

[12:47] Kiersten brings up the socioeconomic factor of the claim. You can't say, this person had back surgery; this is going to be a situation where they're going to be addicted to medical marijuana, or they're going to be addicted to opioids.

[13:08] In her 20 years in the industry, Kiersten has seen that the motivation and the socioeconomic status of the employee, and their need to get back to normal, will always play a factor in whether this becomes an issue or is just something they have to do after surgery.

[13:48] Kiersten has worked with plenty of employees who have had surgery, used opioids for three to five days, and asked what they can have instead, because they don't like this medication. That's something to take into account when having this conversation.

[14:17] Kiersten talks about reimbursement costs and how long the payment would be required for medicinal marijuana, if approved. Is the medical marijuana prescribed for the work accident or for a pre-existing chronic condition that they claim was aggravated by the injury?

[15:11] A Quick Break! RISKWORLD 2026 will be held from May 3rd through the 6th in Philadelphia, Pennsylvania. RISKWORLD attracts more than 10,000 risk professionals from across the globe. It's time to Connect, Cultivate, and Collaborate with them.

[15:27] Booth sales are open now. General registration and speaker registration are also open right now. Marketplace and hospitality badges are now available. Links are in this episode's ...