Still in the Weeds with Medical Marijuana and Workers' Compensation, with Kiersten Cash

RIMScast · The Risk and Insurance Management Society, Inc.

April 7, 202633m 20s

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Show Notes

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 show notes, and be sure to check out RIMS.org for more information.

[15:45] Our guest today, Kiersten Cash, will be a session speaker at RISKWORLD. We are excited for her and also for our just-announced closing keynote, NFL Hall of Famer, Super Bowl Champion, Emmy-winning broadcaster, and entrepreneur, Michael Strahan.

[16:09] Michael Strahan will be on the main stage on May 6th. Justin is super stoked! If you're still on the fence, this is a fine time to smash that Register button and hear from one of the all-time greats.

[16:21] The RIMS Western Regional Conference will be held from October 4th through the 7th in Seattle, Washington. Registration is open, and you can also submit a session. Visit RIMSWesternRegional.com and the link in this episode's show notes for more information.

[16:41] Let's Return to Our Interview with Kiersten Cash of the Children's Hospital of Philadelphia!

[16:49] On May 6th, Kiersten Cash will deliver the session at 10:15 a.m. in 120-BC, "Reefer Madness: Still in the Weeds with Medical Marijuana and Workers' Compensation." Kiersten will co-present with Frank Wickersham, a Workers' Comp defense attorney with Marshall Dennehy.

[17:17] Kiersten says that after the presentation, she and Frank will leave time for Q&A. Kiersten says that audience participation makes her feel like she did her job.

[18:07] Kiersten asks, why should the employer ever have to pay for marijuana. If an employer starts paying for medicinal marijuana for employee A, B, and C, they'll tell their friends they got a medical card after a work injury, CHOP is paying for it, and this is all you have to do to get it.

[19:13] That can become a big issue. Kiersten thinks the biggest thing is for the employer to control what they will pay for, if they have to pay for anything, and to keep it contained, so people who are not hurt but want free medicinal marijuana do not become an issue for Workers' Comp.

[20:14] In Pennsylvania, there is a mental-mental claim. People can initiate a mental-mental claim, for example, if they get into a dispute with a co-worker and don't feel comfortable coming to work because they don't want to work with said co-worker.

[20:31] Mental-mental claims are very hard to prove. In Pennsylvania, nine times out of 10, they are denied. The burden of proof is on the employee to show that their mental issue is from a condition that arose out of something that happened at work.

[21:08] Different states may have different laws that affect Workers' Comp. Kiersten always pays attention to what is going on in the Tri-State Area and the Mid-Atlantic Region. If something passes in one state, it might be about to pass in the next state.

[21:50] Justin asks about Cannabis potentially shifting from a Schedule I to a Schedule III drug. Kiersten has not heard of that happening in Pennsylvania. Schedule III classifies a drug as having a medicinal benefit, as long as it's prescribed by a physician.

[22:32] If the treating physician for the work injury prescribes a Schedule III medicine, the employer could be responsible for ongoing payment indefinitely.

[22:48] Schedule I drugs are not classified as having a medicinal benefit and are considered highly addictive, similar to heroin and LSD.

[23:03] Another Quick Break! The Spencer Educational Foundation's Risk Manager on Campus application period opened on April 1st, 2026, and it will close on June 30th. Grant awardees, colleges, and universities are typically notified in September.

[23:24] The Course Development Grant application deadline for Interval Number 2 will be on June 15th, 2026. Award notifications will be sent out in late July.

[23:39] General Grant applications will open on May 1st, 2026, and the application deadline is July 30th. Internship Grant applications open on August 15th and close on October 15th.

[23:51] Links to each of these grants are in this episode's show notes. Visit SpencerEd.org for more information.

[24:00] Let's Conclude Our Interview with Kiersten Cash of the Children's Hospital of Philadelphia!

[24:12] Kiersten is a department of two: herself and her Workers' Comp Specialist. They run the program together.

[24:39] Kiersten mainly talks to managers, as she does a lot of accident investigation. Kiersten utilizes Teams a lot to establish relationships with the managers. They have a lot of videoconference calls.

[24:55] They send a lot of emails back and forth, but her initial contact with everybody is through Teams, so they know who Kiersten is and what she looks like. She sets up tours and in-person meetings with staff, so they're comfortable with her, and she builds rapport.

[25:20] If something is going on, Kiersten will go into the office and attend whatever meeting she needs to attend. The biggest way Kiersten gets to know a department is by setting up a meeting to do either shadowing or a tour of the department.

[25:37] CHOP is a large organization. Once Kiersten visits a department, and everybody knows her, they're more comfortable with her when it comes to somebody getting injured.

[25:57] Kiersten establishes herself as a contact so that for anything about Workers' Comp, they know to reach out to her.

[26:26] Kiersten also has vendors that help CHOP navigate claims. She builds and maintains vendor relationships as part of her job. She goes to vendor locations, tours their facilities, and meets the staff.

[26:57] Kiersten meets her nurses in person. Kiersten has met in person every nurse who works on her program. She has spoken to them, and they understand how the program is run.

[27:09] Kiersten has a very good relationship with all of the outside vendors who manage her program, so that everybody is on the same page and everybody knows what the common goal is for each claim.

[27:47] Kiersten's advice for the next generation of risk professionals is that Workers' Comp is absolutely the best line of insurance to learn with and hit the ground running in the industry.

[28:03] With Workers' Compensation, you learn about legal, medical, how to pay somebody's wage benefits when they're out of work, what's related to work, and what's not related to work.

[28:22] You learn how to decipher a claim. You learn how to investigate properly, to understand what you should be paying for, and what you should not be paying for. Workers' Comp is very complex. Trust the process.

[28:48] Being a claims adjuster is hard work, but it is only the first step to getting into a much bigger world of risk management. Kiersten says if she had not adjusted claims for 10 years, she would not be able to do the job that she has now.

[19:07] Understand that there is a reason for everything that happens in your career, and that you're not stuck. If a door closes in your face, understand that just because that door closes, it doesn't mean another door will not open.

[29:37] Michael Strahan is the RISKWORLD closing keynote on May 6th. Kiersten will be there. Is she stoked to see Michael Strahan? Kiersten's an Eagles fan, but back in the Strahan days, she would only watch the New York Giants just for him. It's exciting that he's there!

[30:20] Justin says it has been such a delight to finally meet you and to have you on our show. Everyone out there, please remember to go to Room 120-BC for "Reefer Madness: Still in the Weeds with Medical Marijuana and Workers' Compensation," at 10:15 a.m. on May 6th.

[30:53] Special thanks again to Kiersten Cash of the Children's Hospital of Philadelphia. Check out her session, "Reefer Madness: Still in the Weeds with Medical Marijuana and Workers' Compensation," at RISKWORLD on May 6th at 10:15 a.m. in Room 120-BC.

[31:18] Register at RIMS.org/RISKWORLD today.

[31:22] Plug Time! You can sponsor a RIMScast episode for this, our weekly show, or a dedicated episode. Links to sponsored episodes are in the show notes.

[31:50] RIMScast has a global audience of risk and insurance professionals, legal professionals, students, business leaders, C-Suite executives, and more. Let's collaborate and help you reach them! Contact [email protected] for more information.

[32:08] Become a RIMS member and get access to the tools, thought leadership, and network you need to succeed. Visit RIMS.org/membership or email [email protected] for more information.

[32:26] Risk Knowledge is the RIMS searchable content library that provides relevant information for today's risk professionals. Materials include RIMS executive reports, survey findings, contributed articles, industry research, benchmarking data, and more.

[32:42] For the best reporting on the profession of risk management, read Risk Management Magazine at RMMagazine.com. It is written and published by the best minds in risk management.

[38:56] Justin Smulison is the Business Content Manager at RIMS. Please remember to subscribe to RIMScast on your favorite podcasting app. You can email us at [email protected].

[33:09] Practice good risk management, stay safe, and thank you again for your continuous support!

Links:

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"Tom Armstrong on Leading Risk at Comcast and RIMS Delaware Valley Chapter" (2026)

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