Sometime in 2027, a Nebraska worker with a crushed vertebra and a legitimate written recommendation is going to buy a bottle of cannabis tincture at a licensed dispensary, submit the receipt to the workers’ compensation carrier as a medicine that relieves pain, and be told no. What happens next will be decided by three things that are all in motion at once: the text of Nebraska’s Workers’ Compensation Act, the silence of Nebraska’s new medical cannabis laws, and a federal scheduling fight that Nebraska’s own Attorney General is litigating from the other side. This page lays out where every piece stands as of September 2026, how the states that have already fought this out came down, and — because clients ask — where I think Nebraska will land. The prediction is my opinion. The rest is sourced.
Where Nebraska Actually Is, as of September 2026
Nebraska voters passed two initiatives in November 2024: the Medical Cannabis Patient Protection Act, with 71 percent of the vote, and the Medical Cannabis Regulation Act, with about 67 percent. They are codified at sections 71-24,103 through 71-24,114. The patient act lets a “qualified patient” use and possess up to five ounces of cannabis on a written recommendation from a physician, osteopathic physician, physician assistant or nurse practitioner — a signed declaration that, in the practitioner’s judgment, the potential benefits outweigh the harms for the patient’s condition. Note the word: a recommendation, valid for two years, not a prescription. That distinction will matter below.
The laws survived two trips to the Nebraska Supreme Court in September 2026. On September 4, in a unanimous opinion by Chief Justice Funke, the court rejected the signature-validity challenge and upheld the initiatives. On September 11, again unanimously, it dismissed a separate challenge arguing that federal law preempts the acts — but it did so because the plaintiff lacked standing, without deciding the preemption question. That question is therefore open in Nebraska, which is the single most important fact on this page.
The Legislature failed to pass a regulatory framework in 2025 and passed a narrow one in 2026 — commission salaries, a cash fund, fees and background checks — after stripping out the patient registry and qualifying-conditions list that the bill originally carried. The Medical Cannabis Commission’s permanent regulations were approved by the Attorney General on June 30, 2026 and by the Governor on July 1. They contain no list of qualifying conditions; access is recommendation-based. They allow oral tablets and capsules, tinctures, topicals, suppositories, transdermal patches, nasal sprays and liquids for a nebulizer or inhaler, and they prohibit raw plant material, anything smoked or vaped, infused food or drink, artificial flavors and colors, synthetics, and products over 60 percent THC or 40 milligrams per dose. One dispensary is permitted per district court judicial district, twelve in all, with a second where demand warrants. As I write, no dispensary is open; the realistic date for a Nebraska patient to buy a legal product is 2027.
What the Workers’ Compensation Act Says
Nebraska’s comp statute has not been amended to address cannabis, so the claim will be argued on the same words every other treatment is argued on. Section 48-120 makes the employer liable for “all reasonable medical, surgical, and hospital services … appliances, supplies, prosthetic devices, and medicines as and when needed, which are required by the nature of the injury and which will relieve pain or promote and hasten the employee’s restoration to health and employment.” An injured worker’s argument writes itself: a physician recommended it, it is a medicine, it relieves pain, and it is required by the nature of the injury. Nothing in the statute requires a medicine to be FDA-approved or federally lawful. The Compensation Court decides reasonableness and necessity case by case on evidence, which is how it already handles contested treatments, and the carrier’s answers will be the ones carriers give everywhere else: it is not reasonable because it is illegal under federal law, and it is not medically necessary because the evidence is thin.
The Silence in Nebraska’s Cannabis Law — and Why It Matters
Most states that legalized medical cannabis wrote a sentence into the law relieving insurers of any duty to pay for it. Florida’s statute says marijuana “is not reimbursable” under its workers’ compensation chapter. Arizona’s says nothing in the act requires “a government medical assistance program, a private health insurer or a workers’ compensation carrier” to reimburse. Michigan, North Dakota, Louisiana, Illinois, Utah, Pennsylvania, Colorado, Oregon and Arkansas have their own versions. Massachusetts’ highest court used that state’s clause to end the question in 2020.
Nebraska’s acts contain no such clause. I have read both statutes and both sets of regulations, and there is no provision on insurers, health plans, workers’ compensation, reimbursement, employers or the workplace anywhere in them. The initiatives were drafted as patient-protection measures, and the Legislature’s 2026 bill did not add the carve-out. That silence cuts two ways. It means a carrier in Nebraska cannot point to a statutory exemption the way a Florida or Massachusetts carrier can; the fight is purely about section 48-120 and federal law. It also means the Legislature can end the debate any session it chooses by adding one sentence, which is exactly what several states did after the first reimbursement orders arrived. The silence also has a darker side for workers: the acts contain no employment protections, so nothing in Nebraska law stops an employer from disciplining a light-duty worker who tests positive for a product a doctor recommended.
The Federal Problem, and the April 2026 Order That Changed It
Every court that has refused reimbursement has rested on the same premise: marijuana is a Schedule I controlled substance, possessing it is a federal crime, and a state order compelling an employer to pay for it forces the employer to aid a crime. Maine’s high court put it bluntly in 2018 — so long as marijuana remains Schedule I, an employer ordered to pay for it “is thereby required to commit a federal crime.” Minnesota’s reached the same result in 2021. The Solicitor General told the U.S. Supreme Court in 2022 that those decisions were correct.
That premise moved in April 2026. Following a December 2025 executive order on medical marijuana research, the Justice Department and DEA issued a final order, effective April 28, 2026, placing FDA-approved drug products containing marijuana and marijuana subject to a state-issued medical license in Schedule III. A broader hearing on rescheduling all marijuana ran from June 29 to July 15, 2026; the administrative law judge’s recommendation is pending and no final rule on the broader question has issued. Bulk and unlicensed marijuana remain Schedule I. For a Nebraska patient buying a licensed product at a licensed dispensary, the “you are subsidizing a Schedule I crime” argument is weaker than it was in every case decided before this year.
Two complications keep it alive. First, the federal statute’s exception for lawful possession of a scheduled drug requires a “valid prescription or order” from a practitioner, and Nebraska’s law deliberately uses a written recommendation — a carrier will argue the gap is not closed. Second, in May 2026 Nebraska, Indiana and Louisiana petitioned to undo the April order on procedural grounds. Nebraska’s own Attorney General is litigating to keep licensed medical cannabis in Schedule I, which means the strongest defense a Nebraska comp carrier can raise is the position the State of Nebraska is advancing in federal court.
How the States That Have Decided It Split
Reimbursement ordered. New Jersey’s Supreme Court, in Hager v. M&K Construction (2021), held that Congress’s annual appropriations riders suspend enforcement of the federal act against state-compliant medical marijuana, that a carrier paying under a court order lacks the specific intent required for aiding and abetting, and that the state act’s exemption for “private health insurers” does not reach workers’ compensation carriers. New Hampshire’s Supreme Court reached the same result the same year in Appeal of Panaggio: reimbursement is not itself a crime, and a compelled carrier has no criminal intent. New York’s Appellate Division in Quigley v. Village of East Aurora (2021) added that a carrier reimbursing after the purchase “cannot aid and abet a completed crime.” New Mexico’s Court of Appeals ordered reimbursement as early as 2014 in Vialpando, and Connecticut’s compensation review board followed in 2016. In each, the test the worker had to meet was the ordinary one: reasonable and necessary treatment for the compensable injury.
Reimbursement refused. Maine in Bourgoin v. Twin Rivers Paper (2018) found a “positive conflict” between federal and state law and held the federal act preempts a reimbursement order. Minnesota in Musta v. Mendota Heights Dental Center (2021), and its companion case, held the same: compliance would expose the employer to federal aiding-and-abetting liability. Massachusetts in Wright’s Case (2020) relied on its own statute’s insurer exemption, reading it to include comp insurers, and on federal illegality. The Minnesota workers asked the U.S. Supreme Court to resolve the split; on June 21, 2022, after the Solicitor General advised that the refusals were correct but the conflict too narrow for review, the Court declined. The split stands, and every one of those decisions predates the April 2026 order.
Where I Think Nebraska Lands
Here is my prediction, offered as a trial lawyer who will be arguing one side of it, not as a forecast anyone should rely on. The first Nebraska cases will be filed in 2027 or 2028, once dispensaries are open and a treating physician has recommended a licensed product for an injured worker’s chronic pain. They will be argued to individual Compensation Court judges under section 48-120, and I expect those judges to split, because the statute favors the worker and the federal question favors the carrier. The Nebraska Supreme Court will decide it, probably by 2029.
How it decides will turn on the federal schedule at that moment. If the April 2026 order survives the challenge Nebraska itself has brought, and especially if the broader rescheduling to Schedule III is finalized, I expect Nebraska to follow New Jersey and New York: a licensed medical product recommended by a physician is a “medicine” that “will relieve pain” under a statute that says nothing about federal approval, a carrier paying under a court order has no criminal intent, and Nebraska’s cannabis act — unlike Massachusetts’ — gives the carrier no exemption to hide behind. If the order is vacated and licensed medical cannabis returns to Schedule I, I expect the opposite result: our Supreme Court reads statutes closely and has shown no appetite for ordering private parties to violate federal law, and Maine’s and Minnesota’s reasoning would be available to it essentially unchanged. The wild card is the Legislature, which can moot the entire question with a one-sentence carve-out of the kind a dozen states adopted. Given the 2026 session’s reluctance to expand the program at all, I put that at better than even odds before the Supreme Court ever reaches the merits.
One more prediction: the products will matter. Nebraska’s regulations forbid smoking and edibles and permit tablets, tinctures, patches and inhaler liquids in capped doses. A comp claim for a metered oral tablet recommended as an opioid alternative by a pain-management physician looks like medicine to a judge in a way that a bag of flower never did, and the states that ordered reimbursement were, without exception, looking at documented, physician-directed regimens. The claims that win will be the ones built that way.
What Injured Workers Should Do Now
Do not expect a Nebraska carrier to reimburse cannabis voluntarily in 2027; assume it will deny and plan to litigate. If your treating physician believes cannabis is appropriate, have the recommendation documented as part of the injury’s treatment plan — the condition it addresses, the alternatives tried, the opioid-reduction rationale if there is one — because the reimbursement claim rises or falls on the same evidence any contested treatment does: a physician’s opinion, stated to a reasonable degree of medical certainty, that it is reasonable and necessary for the work injury. Keep receipts. Understand that the comp claim and your job are separate questions: Nebraska’s cannabis law gives you no protection from workplace drug policies, and a worker on light duty should know the employer’s policy before filling a recommendation. And if you are told cannabis is “not covered” by Nebraska comp, ask the carrier for the statute that says so. There is not one. There is a court fight that has not happened yet.
I represent injured workers across Nebraska, and I intend to be in the first wave of these cases. If a work injury has left you in chronic pain and your doctor has raised medical cannabis, call (402) 378-9208 or send a message. The consultation is free, there is no fee unless I recover for you, and the medical benefit your claim already carries — including your right to choose the doctor — is the foundation the cannabis question will be argued on. I will update this page as the federal proceedings and the first Nebraska decisions come in.
Sources current as of September 26, 2026. This page states my opinion on an unsettled legal question; it is not a prediction of the outcome of any particular claim.
Your Attorney
Frank Younes
Every page on this site is written by Frank Younes, a Nebraska trial attorney with a published record of verdicts and settlements, selection to the National Trial Lawyers Top 100, and a practice that covers every county in Nebraska and Iowa. No case is handed to an associate — the lawyer you read here is the lawyer who works your case.
More about Frank → · Free consultation: (402) 378-9208
Frequently Asked Questions
Does Nebraska workers’ comp cover medical marijuana right now?
No Nebraska statute, regulation or reported decision requires a carrier to pay for it, and no dispensary is open yet. The question will be argued under § 48-120’s “reasonable … medicines” standard once licensed products exist, likely in 2027.
Does Nebraska’s medical cannabis law say insurers don’t have to pay?
No. Unlike most states, Nebraska’s acts and regulations are silent on insurers, workers’ compensation, reimbursement and employers.
Isn’t marijuana still illegal under federal law?
Bulk and unlicensed marijuana remain Schedule I. Since April 28, 2026, a federal order places FDA-approved marijuana products and marijuana under a state medical license in Schedule III; a broader rescheduling proceeding is pending, and Nebraska is among the states challenging the order.
Which states make workers’ comp pay for medical cannabis?
Courts in New Jersey, New Hampshire, New York, New Mexico and Connecticut have ordered reimbursement; Minnesota, Maine and Massachusetts refused. The U.S. Supreme Court declined to resolve the split in 2022.
Can my employer fire me for using medical cannabis while on workers’ comp?
Nebraska’s cannabis law contains no employment protections. Know your employer’s drug policy before filling a recommendation, especially while on light duty.
What products will Nebraska allow?
Oral tablets and capsules, tinctures, topicals, suppositories, transdermal patches, nasal sprays and nebulizer or inhaler liquids, capped at 60 percent THC and 40 mg per dose. Smoking, vaping, raw plant material and infused foods are prohibited.
More in This Series
Other guides on Nebraska work injury claims.
Chronic Pain After a Work Injury? The Medical Benefit Is Already Yours.
Free, confidential consultation — in English or Spanish. No fee unless I win.
Call (402) 378-9208