Good Cause / Not Good Cause

If you are not taking medications or not regularly seeing a doctor, Social Security has a policy that they may accept this if you have a good reason. You can explain your reason on your disability forms, and when you meet with your doctor, and when you meet with a Social Security doctor.

Good Cause

Social Security may consider some of the following reasons to be good cause:

🌷 Having little or no money and having no health insurance and no free medical care available in your area.

🌷 Having health insurance with co-pays and deductible you cannot afford, and there are no possible programs that can cover this expense.

🌷 Being homebound or unable to travel because of your health is also a good reason, but you will probably need some type of provider who can write a statement for you confirming this.

🌷 Your doctor agrees with you that you stop medication due to severe side effects, and this reason is noted in your medical records.

🌷 Your condition does not require medical care. For example, if you are totally and permanently blind, you do not need to keep regularly seeing a doctor to treat blindness.

🌷 In some circumstances, lacking transportation options may be considered good cause. However, many areas do have programs that provide free transport to doctor’s visits.

🌷 A doctor recommended a treatment or procedure, but then you switched doctors or saw a different doctor who recommended against this. You are following the second doctor’s treatment plan.  It will help if this is clearly written in your chart notes.

🌷 Depending on your circumstances, there may be other good reasons.

Not Good Cause

You are always allowed to switch doctors, however if you are not seeing any licensed medical doctors, this can cause problems. Social Security will not consider it good cause if you stopped seeing any doctor because:

🌷 you did not like your doctors

🌷 you did not like what your doctors said to you

🌷 you did not like their treatments and medications

🌷 you felt your doctors were not helping

🌷 your doctors were recommending medications but you did not want to take them

🌷 you could not afford to go to the doctor you wanted to go to, and you did not want to the doctors covered by your insurance

🌷 you wanted to see only alternative practitioners (herbalists, acupuncture, etc) and no medical doctors

If you do not feel your doctor is helping you, you always have the right to find a new doctor. Switching doctors is not the same as seeing no doctor at all.

Learn More

How To Explain Why You Haven’t Been to the Doctor