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6 reasons why your medical card got declined

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Were you one of the people watching the legislation of medical cannabis in your state? For patients who have rare diseases or chronic conditions and symptoms, a medical card is a passport to explore different types of cannabis products and use them therapeutically.

When medical marijuana is legalized, patients have to apply to see if they are eligible to receive one. The application process includes an evaluation and health history review by a medical doctor. Then, the doctor determines whether cannabis treatments could help the patient.

Some people think that the application process is automatic. If you have one of the qualifying health conditions, you are guaranteed to receive a medical card. Unfortunately, that is not the case. A physician first reviews each application and then by the medical cannabis program. Each state has its review process conducted by real people to determine whether medical marijuana is safe for the patient.

There are a number of reasons why you may have had your medical card declined according to Some are related to common administrative mistakes some people make when applying. Others are related to possible interactions with cannabis and prescription medications you may be taking.

If you were surprised that you were not approved for your medical marijuana card, you still can have legal and administrative recourse. In other words, you may be able to appeal. Learn about the top six reasons that medical cards get declined (and what you can do about it).

1. You didn’t completely fill out the registration information

In some states, the patient is required to complete the registration application on their own. That means providing digital copies of government-issued photo identification. A letter of recommendation from the physician is also required, and some additional information.

Consumers have the option to do a paper application. However, in most states, that delays the application process. Online applications can be processed the same day (with temporary cards issued immediately) in some cases. The patient is able to download and print the card and visit a dispensary right away. It can take up to three weeks for the patient to get an email approval in other states. Then, the medical card arrives in the mail.

The best way to check is to log in to your online profile with your state medical marijuana authority. Review the application. See if there are any sections you failed to complete. Then contact the medical cannabis program for instructions on how to reapply. Some states allow for a second application right away as part of their appeal process. You will, however, be required to pay another application fee.

2. The photo you provided was not accepted

Passport pictures are finicky. They sound pretty straightforward when the medical cannabis program provides dimensions. They must be against a plain background (like a white wall), and you must be unsmiling in the picture. But that is just the start of the requirements for a legal identification photo.

  • The size of your head must be between 1” and one 3/8ths inch or 50% and 69% of the image’s total height from chin to the top of the head.
  • The photo must have been taken within the last six months and reflect your current appearance.
  • The full-face view must be front-facing and visible. This includes brushing hair back away from the face and eyes.
  • No hats or eyeglasses. Smartphones or other personal tech or devices (like AirPods) must not be visible in the picture.
  • Both eyes must be open. Mouth must be closed.

There are plenty of apps online that will help you take a good passport picture with your smartphone. But sometimes it is better to visit a photographer that specializes in passport-style pictures. They have the experience to get the picture done to perfect specifications.

3. Your practitioner is not legally permitted to recommend medical marijuana

Every year, more physicians and medical groups are providing medical card health evaluations. Do you live in a state that has recently legalized telemedicine? That also means that marijuana doctors can provide the required health evaluation online. It is possible (in most states) to get your medical card online.

However, some physicians are not legally permitted to make the recommendation for medical cannabis. For instance, in some states, only licensed and board-certified physicians can provide the evaluation. In other states, nurse practitioners, osteopathic doctors (Dos), naturopathic doctors (NMDs or NDs) may be permitted.

In 2020, more than 600 patients had to reapply because of a fraudulent physician. It was because the physician that certified their health evaluation had an expired license. Make sure you are double-checking when you choose a physician to get your evaluation.

4. Parental consent is required

In a state that has legalized adult-use (recreational) marijuana, you have to be 21-years of age or older to enter a dispensary and purchase. In states where only medical cannabis is legalized, you may be able to get your medical card (with or without parental consent) at the age of eighteen (18).

If you applied for a card and under the age of eighteen, you would need to get a written consent from your parent or caregiver, who is over the age of 21. In some states, parental consent is not enough. You would be required to have a parent or legal guardian apply with you as a caregiver. They would hold the medical card and be legally permitted to purchase medical cannabis for you.

5. Your payment for registration didn’t process

For whatever reason, the payment on your debit or credit card bounced. But they didn’t call you to tell you? When you consider that the administration is constantly busy processing new applications, don’t expect them to chase you down for the fee. It’s your responsibility.

The medical marijuana registration team may let you know. Or they could simply notify you that your application has been denied. And leave it up to you to figure out. To avoid delays, check your bank account. And if the charge doesn’t post to your online banking, call your bank, and then call the medical marijuana program to schedule repayment.

6. You don’t have a qualifying health condition

We put this one last on the list. Ideally, before you start the application process, you would want to double (or triple) check. If you don’t have one of the qualifying health conditions accepted by your state medical marijuana program, you aren’t going to get very far.

Each state has a website for information about its medical marijuana program. And the list of qualifying conditions is featured prominently. If you do not have a formal diagnosis of at least one of the required conditions, you will not be able to get your medical card.

This unfortunate situation excludes some patients whose diagnosis does not appear on the list of accepted health conditions. The U.S. Department of Health and Human Services estimates there are up to 30 million Americans who have a rare disease diagnosis. In many cases, these diseases are not well known because they are so rare. And because they impact a small percentage of patients, researchers have an uphill battle to get funding for rare disease research.

It also means that very few physicians may have a lot of experience treating rare diseases. And as such, patients with an RD may find it difficult to get a recommendation from a physician. In some states, patients can appeal the decision. However, the qualifying health conditions are stipulated in legislation. This means the patient may have to lobby with organizations to get a condition added. And that can take years, as it is the constitutional amendment of state legislation.


The first step is to review your application and see if a clerical error was the reason why you didn’t get approved. Then, contact your state medical marijuana program for assistance. You may be able to file a formal appeal with your physician and reapply.

Augusta Health Augusta Free Press Kris McMackin CPA
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Augusta Free Press