Use of medical cannabis for the treatment of work-related health conditions: Proposal instructions

Section 1: Funding overview

The objective of the WSIB Research and Grants Program is to enhance workplace injury and illness insurance system outcomes by supporting innovative proposals that help advance our strategic mandate.

This is accomplished through highly practical, expert research studies and training initiatives delivered by professional individuals and organizations that address current and emerging challenges, and strengthen Ontario's workers' compensation system now and in the future.

Systematic review grants support research issues of immediate relevance to occupational health and safety, and may help to answer key questions in workers' compensation. Outcomes from systematic reviews may be considered by the Workplace Safety and Insurance Board (WSIB) to determine whether the scientific evidence meets the recommended standards for scheduling and/or policy development, or for adjudicative support for case-by-case decision-making.

Section 2: Funding opportunity

The WSIB is interested in awarding a grant for a systematic review that specifically aims to evaluate: a) the current state of evidence on the therapeutic use of medical cannabis for the treatment of health conditions that can be work-related, as indicated below; b) evidence supporting the use of specific classes of medical cannabis (e.g., dried cannabis, cannabis edibles, cannabis extracts and/or cannabis topicals), including information on dose of delta-9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD), as well as cannabigerol (CBG) and cannabinol (CBN) where available, for the treatment of conditions that can be work-related; and c) evidence of any risks, adverse events, or harms associated with the therapeutic use of medical cannabis for health conditions that can be work-related.

For the remainder of this appendix:

the term “medical cannabis” refers to any and all classes of non-pharmaceutical cannabis products (i.e., dried cannabis, cannabis edibles, cannabis extracts and/or cannabis topicals, if available) that are included under the federal Cannabis Act and Cannabis Regulations that may be used for therapeutic or medical purposes, including products containing cannabinoids such as THC, CBD, CBG, CBN, etc.
“non-pharmaceutical cannabis products” refers to cannabis products that are not produced in controlled pharmaceutical manufacturing environments and which have not been issued a drug identification number
“currently designated work-related conditions” include health conditions set out in the WSIB’s Operational Policy Manual document 17-01-10, Cannabis for Medical Purposes. These conditions include neuropathic pain; spasticity resulting from a spinal cord injury; nausea and vomiting associated with cancer chemotherapy; loss of appetite associated with human immunodeficiency or acquired immune deficiency syndrome; or pain and other symptoms experienced in a palliative state

The WSIB specifically requests that the systematic review examine and evaluate the scientific evidence from primary research studies published since 2016 (the end of the literature review period covered by the NASEM report) for the use of non-pharmaceutical medical cannabis for health conditions which are currently designated work-related conditions and potential work-related conditions, including assessment of:

therapeutic benefit
dose, route of administration, and duration of treatment, where available
any risks, adverse events, or harms resulting from treatment

Please review the detailed requirements of the final report for additional information.

The review should follow generally accepted methods for the reporting (i.e., Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA 2020]) and conduct of systematic reviews.

Refer to Proposal Instructions Appendix C for detailed requirements for the systematic review.

Required outputs

For the purpose of this research competition, a systematic review is considered to be a review of a clearly formulated question that uses systematic and replicable methods to identify, select and critically appraise all relevant scientific research, and to collect and analyze data from the studies that are included in the review. Methods used should also minimize bias and ensure results are reproducible. Statistical methods such as meta-analyses should be used, if appropriate, to analyze and summarize the results of the included studies. A rationale and the appropriate supporting analysis should be clearly identified to validate the inclusion or exclusion of meta-analytic techniques.

This information may be considered by the WSIB to determine whether the scientific evidence meets the recommended standards for scheduling and/or policy development, or for adjudicative support for case-by-case decision-making.

Eligibility criteria

1. Who can apply to the WSIB Research and Grants Program?

The research team will require a minimum of three (3) team members including:

At least one member with a doctorate in epidemiology, or related fields relevant to this research request
At least one member of the team must have demonstrated experience conducting systematic reviews including meta-analyses related to disease etiology

In addition, the ideal research team may also include:

at least one member who is a pharmacist or has a background in pharmacology.
at least one member who is a MD with a specialization in occupational medicine, the treatment of chronic pain, or the treatment of mental stress injuries (e.g., post-traumatic stress disorder).

Expert researchers affiliated with an eligible applicant organization:

Publicly funded universities or colleges
Public hospitals with a specialized research area
Not-for-profit or registered charitable organizations with the capability and capacity to conduct research
Canadian non-governmental organizations with the capability and capacity to conduct research
Other organizations that have the capability and capacity to conduct research and are not privately owned and operated may also be eligible for a WSIB grant.

Private organizations are not eligible to apply for a WSIB research grant as a project or secondary lead. Private organizations may be identified as a partner or collaborator of an eligible applicant organization.

2. What legislation guides the WSIB Research and Grants Program?

Proposals must be consistent with Section 159(5) of the Workplace Safety and Insurance Act, which provides the WSIB with the authority to offer grants for the purposes of research, training and investigations in amounts and subject to such conditions as the Board considers acceptable.

3. What is the duration of the grant funding for this initiative? What is the maximum funding limit per year for this initiative?

One grant will be awarded in the amount of $185,000 for a term of up to 18 months.

Refer to Appendix B for detailed funding use restrictions.

Project team descriptions

Project Lead

The Project Lead must be based in or formally affiliated with an eligible host organization (university, college, hospital, research institute or other qualified not-for-profit organization).

The Project Lead is responsible for managing and monitoring the proposed activities, including administrative and financial responsibility for the grant. The Project Lead is not eligible to receive salary support from a WSIB grant.

Secondary Lead (Co-lead)

The Secondary Lead shares responsibility for the grant and, in most cases, should be able to assume Project Lead responsibilities as necessary. The Secondary Lead is not eligible to receive salary support from a WSIB grant.

Co-Applicant

Co-Applicants may or may not have a formal affiliation with the project host organization, but will take responsibility for specific administrative and scientific aspects of the project. Co-Applicants are not eligible to receive salary support from a WSIB grant.

Project Personnel

Project Personnel include undergraduate and graduate students, postdoctoral fellows, research assistants, coordinators, technicians, programmers, analysts, etc., who may contribute to the activities of the Project Lead. Project Personnel may receive salary support or honoraria from the grant in keeping with the funding use restrictions.

Collaborator

The project may include collaborators who are central to the project and not otherwise identified in the categories above. Their role in the proposed activities is to provide a specific service (e.g., access to equipment, training in a specialized technique, statistical analysis, access to a patient population, etc.). Collaborators may be eligible to receive project funds for specified services or resources if it can be demonstrated that their contribution is essential to the work being undertaken and not otherwise available to the project team. Project advisory committee members are generally viewed as collaborators and may not be eligible to receive grant funds for the time they may contribute to the project.

Evaluation and selection process

The current funding initiative is a competitive process and all applicants are required to submit a detailed proposal for consideration of funding. Each application will undergo a rigorous multi-stage review process designed to assess scientific credibility, transparency and accountability, and emphasize relevance to the funding objective and workers’ compensation system.

Stage 1: Peer review by external experts to ensure the validity of the research project and design. Applications that fail peer review will not proceed.

Stage 2: Relevance review by an internal panel of WSIB staff to ensure alignment to the funding objectives and requirements. This review may happen concurrently with Stage 1 in order to address questions regarding methodology and outputs.

Stage 3: Final funding decision by the WSIB Grant Advisory Committee, including the project sponsor.

Refer to Appendix A for detailed requirements of the evaluation criteria.

Managing and measuring progress

WSIB grant recipients will be required to regularly report on their progress to ensure we can support the recipient in early identification and removal of barriers.

The successful applicant will be required to complete a final report as a condition of funding, which will be subject to a peer-review. Responses to the peer review comments must be provided to the WSIB, and for substantive peer review issues, corrections to final report may be required. Additionally, a requirement to present the overall findings of the systematic review to WSIB management will occur following the peer review of the final report.

The final report delivered to the WSIB will be in electronic format and published within the WSIB Reference Centre.

Refer to Appendix C for detailed requirements of the final report.

Submission instructions

Click here to register and create a profile in our grant management system. Carefully review the instructions under the WSIB Systematic Review - Medical Cannabis program and provide comprehensive answers to the tasks and application questions and required signatures.

Deadline for the proposals is Friday May 16, 2025 at 5:00 p.m. (ET).

Proposals received after the deadline will not be included in the application and selection process. Incomplete proposals will not be accepted.

Appendices

Please include references in this section and clearly identify the section that the pages belong to.

Program contact information

If you have questions regarding the WSIB Research and Grants Program, please contact us by:
Email: [email protected]

The WSIB appreciates the time and effort it takes to submit a proposal. Thank you for your dedication to Ontario’s workers’ compensation system.

Appendix A

Proposal evaluation criteria

Proposals will be evaluated based on criteria and considerations aligned to the following categories:

Workplan and accountability
Scientific merit
Research design and methodology
Experience of the research team
Budget
Project risk assessment

The major emphasis of the evaluation will be on the project’s ability to deliver clear outcomes that align to the required objectives and can be successfully communicated at the end of the project.

The evaluation process also considers reputational risk to the WSIB. This assessment is inclusive of any partners or collaborators identified in the proposal.

Appendix B

Additional considerations

Funding restrictions

Grant recipients are prohibited from using WSIB funds (“Funds”) for the following purposes; and therefore, applicants should ensure the costs outlined below are not included in a proposal to the WSIB Research and Grants Program:

Salaries and stipends

The Funds may not be used towards salary support for any key team member who is a full-time researcher, a full-time faculty member of a college or university, or a full-time educator, trainer or healthcare professional, except where (i) the individual receiving such support is compensated entirely from research monies or their salary will be materially reduced as a result of working on the Project, (ii) the salary support will not result in the individual being compensated twice or more for the same work, and (iii) the use of the Funds for this salary support is explicitly identified in Schedule C. Funds may be used towards other Project Team members such as co-ordinators, technical and other support staff. Funds may only be used towards actual direct salaries, not charge out rates (i.e. the amount paid to an employee and specified in the Budget). The WSIB reserves the right to set a ceiling on its contribution to salaries on a classification basis.

If the person for whom salary support is being requested is a full-time employee of the Grant Recipient, the Funds may be used towards a salary value based on the number of days or part days that the individual will work on the project, provided that such amount may not exceed a reasonable amount based on the Grant Recipient’s regulations, policies or guidelines. If a person is to be employed on a contract basis, then Funds can be used towards compensation calculated on an hourly, daily, weekly or monthly basis. The Funds may only be used towards compensation received by the employees and may not include an allowance for overhead and/or benefits.

The Funds may be used towards a salary contribution for graduate students and postdoctoral fellows engaged on the Project, provided such amount will not exceed an amount determined by following normal university or college regulations, policy or guidelines.

Employee benefits

Where Funds are permitted to be used towards salary support (in accordance with A.1), no more than 20% of such salary support can be used towards the cost of benefits for employees (e.g., E.I./U.I.C., C.P.P., health benefit coverage).

Indirect or overhead costs

The Funds may not be used towards capital expenditures, overhead costs, maintenance costs, and other incidental expenses. IT hardware or software purchases may not be purchased using the Funds unless they are explicitly identified in Schedule C.

Publications, reports and memberships

The Funds may not be used to purchase subscriptions to or individual copies of scientific journals, computer manuals, books or other publications. The Funds may not be used towards membership fees to societies. However the Funds may be used towards reasonable costs incurred in the publication of Project results, which may include printing material for presentation at conferences (with acknowledgement of the WSIB, as required by this Agreement), to the extent explicitly set out in the Budget and approved by the WSIB.

Conferences

No more than $1,500.00 of the total Funds may be used to support knowledge and dissemination at conferences (registration and/or publication fees). The Funds may not be used towards travel, accommodation, or meals for conferences.

Personnel hiring

The Funds may not be used towards any costs associated with hiring of project personnel, including salaries of hiring personnel, advertising costs, or travel costs.

Hiring of consultants

The Funds may not be used towards consulting fees. The use of Funds towards any external expert (e.g. a statistician) must be clearly identified within the Proposal and Budget, including a detailed description of their role and compensation.

Administration fees

The Funds may not be used towards administration or tuition fees.

Materials and supplies

The Funds may not be used towards materials and supplies, including office supplies, at a fixed rate; they may only be used on an "as used basis".

Purchase of equipment

No more than 10% of the total Funds may be used towards equipment purchase expenditures. Provided an equipment purchase is explicitly included in the Budget (including a total cost and a per unit cost), any equipment purchased with the Funds becomes the property of Grant Recipient.

Travel, meals, accommodation, hospitality, entertainment, gifts

The Funds may not be used for travel, meals, accommodation, hospitality, entertainment, or gifts of any kind (“Travel and Related Expenses”) except to the extent such Travel and Related Expenses are expressly included within the Budget and are directly related to Project activity. The Funds may not be used, under any circumstances, towards (i) entertainment of any kind; (ii) any purchase of alcohol; (iii) costs associated with any incidental expenses while travelling, including tips, dry cleaning, and long distance calls; (iv) gifts, including gifts for investigators and research staff; or (v) Travel and Related Expenses associated with attending meetings at the WSIB’s offices in Toronto, Ontario.

Grant Recipient’s use of Funds towards Travel and Related Expenses shall be subject to the terms and limits (including maximum rates) that are applicable to the WSIB and its employees in the Management Board of Cabinet Travel, Meal, and Hospitality Directive dated January 1, 2020 (as may be amended) (the “Directive”). Where the Directive requires any approvals (including a ministry approval), the Grant Recipient shall seek such approval from the WSIB’s Representative in writing in advance.

Without limiting the foregoing, to the extent Funds are approved for use towards travel: (i) all travel must be done in the most practical and economical manner possible; and (ii) if air travel is authorized, flights must be economy class.

The WSIB reserves the right to place additional restrictions on the use of Funds towards Travel and Related Expenses, upon giving reasonable notice to the Grant Recipient.

Conflicts of interest

The applicant organization must acknowledge if there is a perceived, potential, or actual conflict of interest (a “Conflict of Interest”) associated with the proposal. The applicant organization must also promptly inform the WSIB in writing if a Conflict of Interest becomes known at any time.

A Conflict of Interest includes, without limitation, the following:

situations, circumstances, or conduct that could give a grant candidate an unfair advantage during the proposal selection process or compromise the ability of the candidate to perform its obligations under a contract with the WSIB
the offer or giving of a benefit of any kind, by or on behalf of a grant candidate to anyone, employed by, or otherwise connected with, the WSIB, and
additional circumstances described in the WSIB’s Code of Business Ethics and Behaviour (available at www.wsib.on.ca).

For the purposes of this funding opportunity, the WSIB considers those with prior or current funding by, or have investments in, cannabis companies to have a conflict of interest.

The WSIB reserves the right to:

solely determine whether any situation or circumstance constitutes a Conflict of Interest
require grant candidates participating in the proposal selection process to declare any Conflict of Interest
disqualify grant candidates from the proposal selection process due to a Conflict of Interest, and/or
prescribe the manner in which a grant candidate should resolve a Conflict of Interest in order to avoid disqualification.

Confidentiality and Freedom of Information

The information submitted in connection with this proposal may be disclosed by the WSIB in accordance with FIPPA (the Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.F.31, as amended).

Intellectual property rights

A component of the Grant Agreement will be provisions that provide the WSIB with a non-exclusive, perpetual and irrevocable right to use, reproduce, display and distribute copies and prepare derivative works of all material produced from the grant activities. The WSIB may do so in any manner it considers useful or helpful to the administration of the Workplace Safety and Insurance Act.

Grant agreement

Successful applicant organizations must complete a grant agreement satisfactory to the WSIB (“Grant Agreement”) prior to receiving grant funds.

Appendix C

Funding objectives – Guidance to researchers

Detailed requirements

The systematic review should follow generally accepted methods for the reporting (i.e., Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020) and conduct of systematic reviews. The systematic review should specifically evaluate: a) the current state of evidence on the therapeutic use of medical cannabis for the treatment of health conditions that can be work-related, as indicated below; b) evidence supporting the use of specific classes of medical cannabis (e.g., dried cannabis, cannabis edibles, cannabis extracts and/or cannabis topicals), including information on dose of delta-9-tetrahydrocannabinol (THC) and/or cannabidiol (CBD), as well as cannabigerol (CBG) and cannabinol (CBN) where available, for the treatment of conditions that can be work-related; and c) evidence of any risks, adverse events, or harms associated with the therapeutic use of medical cannabis for health conditions that can be work-related.

therapeutic benefit
dose, route of administration, and duration of treatment, where available
any risks, adverse events, or harms resulting from treatment

Final report

The final draft report is due within 18 months of the effective date of agreement, and will be subject to a peer-review as arranged by the WSIB. The final report will need to address peer-reviewer comments and be delivered within 2 (two) months of receipt of peer-reviewer comments*.

* It is estimated that the peer-review of the final draft report will take approximately 4 weeks.

The final report should include the following elements:

a) Executive summary;

b) Lay language summary (i.e., short summary describing the project and findings in simple, non-technical language suitable for sharing with a general audience);

c) Background and scope;

an outline of the research questions and project description
a summary of the pharmacology of cannabinoids
a summary of current Ontario or Canadian clinical guidelines regarding the use of medical cannabis in the treatment of various health conditions, including benefits and risks of treatment using cannabis
a summary of relevant and previously published systematic reviews and meta-analyses on the use of medical cannabis for various health conditions
a discussion of methodological challenges with evaluating the use of cannabis products in a therapeutic context
overall objectives of the systematic review

d) Methods;

comprehensive and transparent search strategy for sources of relevant evidence, including keywords, databases, and resources used (e.g., librarian)
eligibility criteria (e.g., inclusion and exclusion criteria) with supporting rationale, recorded reasons for exclusion, study screening methodology, eligibility criteria applied independently by two or more reviewers
data extraction (e.g., study authors, publication date, country/region of study, study design, indication(s) studied, formulation(s) of cannabis, route(s) of administration, dose, duration of treatment, control group, study population characteristics and size, and health outcome assessment/diagnosis, follow-up period, key findings, adverse events),
approach used for critical appraisal of study findings (e.g., quality assessment criteria/tool/checklist), including how issues such as selection or information bias, contamination bias, detection bias, confounding, and random error will be considered or addressed in the analyses
description of statistical analyses used; including any statistical software, and the statistical methodology used for the quantitative assessment and synthesis of study findings, for example a meta-analysis (fixed effects versus random effects model) or other methods used to weigh and synthesize the evidence; should include assessment of bias in meta-analysis, such as publication bias, and sources of heterogeneity
approach used for overall synthesis of the evidence
- explanation of the criteria/framework used to determine a level of evidence including an explanation of how the level of evidence was reached in each analysis

e) Results;

results of the literature search
presentation of the systematic review findings on the therapeutic benefit of medical cannabis both quantitatively and qualitatively (e.g., evidence table, outcome measures) for both currently designated work-related conditions and other potential work-related conditions
- include study characteristics such as study design, geographic region, study population, reference population, formulation of cannabis, route of administration, dose, duration, control group, where applicable, as well as effect estimates and follow-up period
  - if the study provides more than one effect estimate, indicate which estimate is used in analysis
- results of the quality appraisal, including examination of methodological issues of individual studies (i.e., bias, confounding, power)
  - specifically examining how methodological challenges were addressed and their impact on study results (e.g., selection bias, information bias, bias in outcome measures, detection bias, blinding to placebo)
- consideration of findings for all studies in comparison with those studies deemed to have higher methodological quality
- graphical representation of systematic review findings (e.g., forest plot)
presentation of any findings related to risks, adverse events, or harms, including any information on factors associated with these outcomes (e.g., dose, formulation)
statistical analyses, including test of heterogeneity and quantitative assessment of study findings, if appropriate, such as meta-analysis
presentation of the level of evidence/certainty reached in each analysis

f) Discussion;

overall findings of the systematic review describing the therapeutic benefit of medical cannabis in the treatment of health conditions that can be work-related:
- any evidence for the use of medical cannabis in the treatment of currently designated work-related conditions,
- any evidence that may support the use of medical cannabis in the treatment of other potential work-related conditions,
- any considerations regarding formulation, dose, or route of administration,
- any factors associated with risks, adverse events, or harms that may indicate a precaution or contraindication for the use of medical cannabis,
- evaluation of the limitations of included studies (e.g., selection bias, information bias, confounding, heterogeneity), and how these may have impacted the overall conclusions
- how the results of the quality assessment, any sensitivity analyses, and overall weighing of the best evidence factored into the assessment of therapeutic benefit
- critical evaluation of the current state of evidence, including previous pooled studies or meta-analyses
- presentation of the strengths and limitations of this review and their potential impact on the findings

g) Conclusions;

Statements about overall level of evidence/certainty for the use of medical cannabis in the treatment of health conditions that are currently designated and other potential work-related conditions
Where possible, statements on appropriate formulation, dose, administration, and treatment duration
Statements about general factors to consider when weighing the risks and benefits of therapeutic cannabis use

h) Appendices - Supplementary evidence tables of individual study results

i) References.