Case In Point
Arbitrator Dismisses Grievance over Denial of Benefit Reimbursement for Medical Marijuana
Date: March 10, 2016
Arbitrator Sheehan recently dismissed a grievance by the Hamilton Professional Fire Fighters’ Association which asserted that the denial of a claim for payment of the grievor’s spouse’s medical marijuana breached the collective agreement.
The grievor had submitted a claim to Manulife under the City of Hamilton’s benefit plan, seeking reimbursement for its costs. He had attached a receipt from a licensed producer of medical marijuana to the claim form. The written order to the licensed producer was accompanied with a medical document completed by a doctor. According to the medical document, the grievor’s spouse required a dosage of three grams per day for a period of six months, arising from two medical conditions.
The City of Hamilton has very specific and detailed language setting out the requirements that must be met for coverage to be provided:
Claims submitted directly to Liberty Health must include original receipts and a completed claim form including the following: your name and complete address; your group and identification numbers; group name; claimant’s date of birth; dependent’s name (if claim is on behalf of a dependent or spouse) plus relationship to you. Drug claims must indicate the prescription number, name, strength and quantity of the drug plus the drug identification number.
Manulife denied the claim because the expenses claimed were not covered by the group benefit plan and Health Canada had not assigned an identification number (“DIN”) to the drug.
Arbitrator Sheehan provided a detailed overview of the existing legislative and regulatory framework associated with medical marijuana. Ultimately, he decided the case based on the language of the collective agreement and the standard principles of collective agreement interpretation, finding, among other things, that the grievor failed to satisfy the mandatory requirement in the collective agreement that a DIN must be indicated.
Whether or not this is the end of this case remains to be seen. The Association indicated at the hearing that, depending on the outcome of the grievance, it might pursue this matter further by asserting that there was a violation of the Canadian Charter of Rights and Freedoms and/or the Ontario Human Rights Code. The parties agreed to bifurcate the hearing on the basis that the Association’s arguments pertaining to the Charter and Code would be dealt with, if necessary, subsequent to the determination as to whether there had been a violation of the collective agreement.
The Corporation of the City of Hamilton and the Hamilton Professional Firefighters’ Association (26 February 2016, Sheehan)
