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Fighting WCB Nova Scotia for Medical Cannabis Coverage – Melissa Ellsworth’s Story – Cannabis News, Lifestyle


Melissa Ellsworth is a psychiatric nurse who worked in federal corrections. After a work injury, she suffered from severe chronic pain and her life changed forever. When pharmaceutical medications did not work, her doctor recommended that she switch to cannabis. This suggestion gave her unprecedented pain relief, but she also started the fight of her life. The Workers’ Compensation Board (WCB) of Nova Scotia has no problem with opiate medications; medical cannabis is a whole different matter. Getting cannabis covered by the WCB has been an uphill battle in Nova Scotia; This is the story of Melissa Ellsworth.

Photo courtesy of Melissa Ellsworth

Opiate injury

In 2006, Melissa Ellsworth was working as a licensed practical nurse at a mental institution in Dartmouth, Nova Scotia. She was hit in the head by a chair and suffered injuries that will follow her for life. Left with neuropathic pain in her neck, jaw, shoulders and head, Melissa took various prescriptions to try to manage and get back to work. At one point she was taking a mixture of opiates, sedatives and benzodiazepines; up to twenty pills a day and all covered by the Workers’ Compensation Board of Nova Scotia. Everything changed when she started using THC.

Synthetic to natural THC

“I ran the medicine bet when it came to prescriptions and traditional medicines. Nothing worked. Finally, they put me on Cesamet, which is basically a synthetic THC. Once I hit the 6mg max, my pain doctor at the time suggested I switch to cannabis. – Melissa Elsworth

Image courtesy of PubChem

If you consume a lot of synthetic THC, switching to the natural form seems like an obvious choice. When you work for the federal government, it’s just not that simple. As a healthcare worker in the prison system, she had great reservations about using cannabis. With the encouraging results of synthetic THC and her doctor’s recommendation, she decided to give it a try.

Cannabis use

Today, Melissa is able to manage her neuropathy using only cannabis. She will vape when she needs quick pain relief. Plus she makes her own edible and hot topics. As a healthcare professional, Melissa only orders from a licensed producer and she knows what’s best for her. When it comes to reducing pain, sour diesel and cannabliss are its most effective strains. When these buds are in stock, she will place a mail order but inventory is never guaranteed.

An average month of cannabis medicine costs around $1900. She has a prescription for all of this. She completely replaced a heavily addictive medication routine with natural herbal remedies. The only problem is paying for it.

WCB Nova Scotia – Medical Cannabis Policies

When you browse the WCB Nova Scotia website, you can find all of the medical cannabis forms and policies. Such a document is a Sample Patient 2 Treatment Agreement and he specifically mentions heroin and cocaine. If you want to use medical cannabis instead of prescription opiates, you must sign a form and promise not to take heroin. However, you cannot try medical cannabis without first using heavy pharmaceuticals, including opiates.

Image created by the author

Nova Scotia’s WBC released a document titled ‘Medical Cannabis Guidelines‘ and it outlines their coverage criteria. According to this document, a patient must have exhausted pharmaceutical trials before coverage can be considered. Concretely, this means failure.to meet adequate testing of a minimum of THREE DIFFERENT categories of first line agents (eg TCA, SNRI, Gabapentinoid) and/or second line agents (eg Tramadol or Opioids). If an agent category has not been tested, a compelling reason must be provided.“In addition, the patient should try synthetics cannabinoids for at least twelve weeks. The WCB will only review coverage once all medications have been found to be ineffective.

Nova Scotia WCB Cannabis Coverage Limits

When it comes to coverage limits, the guidelines are strict and unexplained.

The medical cannabis and route of administration authorized for the worker must meet all of the following conditions:

  • The route of administration should not involve smoking.
  • The daily amount of dried medical cannabis should not exceed three grams per day.
  • Medical cannabis should be CBD-rich with minimal THC.
  • The THC percentage of medical cannabis must not exceed nine percent.
  • Milligrams (mg) of THC per day should not exceed 30 mg, but in no case should exceed 75 mg. The daily amount of dried cannabis should not exceed 3g/day. If other forms are prescribed (i.e. oil), they should be converted to a similar ratio and amount.
  • Cannabis should not be grown on site.

Fighting for Cover – Nova Scotia WCB Tribunal

For Melissa Ellsworth, the road to recovery has been long and difficult. Healing was difficult and stressful, but getting coverage was a struggle. Initially, she asked her WCB case manager to cover her medical expenses, but the request was denied. So she asked again. When it was rejected a second time, she took it to a hearing officer; they also denied the request. Melissa didn’t give up. In 2018, her claim was taken to court and eventually, she won her right. After a five-year bureaucratic battle, Nova Scotia’s WCB would cover the cost of four grams of cannabis a day.

“My Cesamet was 100% covered without a doubt. I picked it up at the pharmacy the same day. All increases from 1mg/day to 6mg/day of Nabilone or Marinol (first trial) were unquestioned and I did not need a court. I didn’t need a court for opiates, gabapentin or sleeping pills…and the increases weren’t questioned/challenged either. – Melissa Elsworth

Still fighting for insurance – Nova Scotia WCB Tribunal #3

Over time, Melissa Ellsworth developed a tolerance to cannabis that necessitated a change in her prescription. Her doctor increased her per diem in 2019, 2020 and 2022, but all coverage increases were denied by the WCB. This is where things really go wrong: when her first raise was turned down, the recommendation was opiate medication. The WCB would approve all costs associated with a narcotic prescription, but it would not cover an extra gram or two. Again, Melissa prepared for battle.

Currently, Melissa Ellsworth has won eight WCB Courts.

Photo courtesy of Melissa Ellsworth





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