A “nexus” is a link or connection between two or more things. In order to qualify for disability benefits, a veteran must be able to prove that their medical conditions are the result of their military service (i.e. “service-connected“).
Thus, the purpose of a Nexus Letter is to clearly connect a veteran’s current medical condition either to another service-connected condition or to circumstances directly related to military service. A nexus letter may be prepared by a physician or other medical professional and explains how a Veteran’s medical illness or condition is directly related to his military service. While a nexus letter is not required when applying for VA disability benefits, it can make the difference between an application being approved or denied. A nexus letter can be submitted with an initial application, while the VA is evaluating whether the Veteran is eligible for benefits, or after an adverse C&P exam.
The connection matters because there are three key elements of successful VA claims:
A current, diagnosed disability
An in-service stressor (an injury, illness, traumatic event, etc.)
A connection linking parts 1 and 2
A nexus letter is especially crucial if no medical records were provided in support of the application and the C&P examiner does not find a link between the Veteran’s illness or disability and his military service. In this situation, the application will be denied unless a nexus letter is submitted.
Image showing Veteran meeting with Doctor
Nexus Letters are essential for any condition on a VA Disability Claim that is not automatically considered service-connected. Conditions are automatically considered service-connected if 1.) there is ample evidence that it occurred during the veteran’s service or 2.) it is on the VA Presumptive List and the veteran meets the qualifications for the list.
How to Make a Nexus Letter Stronger
It is best to choose a doctor that is currently treating you to write a nexus letter on your behalf. You should select a doctor that is board-certified in the area of health that is at issue in your case.
The physician must use specific language, certain phrases, and the correct medical standard when writing the letter. Here are some tips on how to ensure that the nexus letter strongly supports your claim:
The letter should be brief, but thorough. It should focus on the facts and the doctor’s conclusions.
The doctor should mention in the letter that he has reviewed your entire VA file and medical records. If he fails to do so, the VA may disregard his letter.
The letter should mention that the doctor has recently examined you. The VA may find the physician’s conclusions more persuasive if this is true.
The physician does not need to draw an absolute conclusion as to the nexus between your disability and your military service.
What Needs To Be Included In A Nexus Letter?
A VA nexus letter should include four key elements:
Medical expertise: Your nexus letter should be written by a medical expert in the area of your medical condition in question and include a statement verifying that fact. Additionally, the physician writing the nexus letter must assert that they have fully and thoroughly reviewed your medical records including your VA claims folder (also known as your C-file).
Evidence: Your nexus letter should include additional evidence vouching for your disability, such as buddy letters, prior medical records, and your military service records.
Research that supports the physician’s conclusions: This could be references to studies published in medical journals and other accounts in medical literature.
A conclusion: The writer of your nexus letter simply needs to determine whether your in-service stressor is "more likely than not" to have caused your current condition. Anything less strongly worded will not suffice.
While this may sound like a lot, VA nexus letters are typically quite short.
A strong Nexus letter is compelling, well-researched, and credible. Letters should be written on the doctor’s letterhead and signed by the doctor to boost credibility. To increase your chances of a successful claim, letters should include the following:
A statement confirming the author has carefully reviewed the veteran’s medical history – such as the patient’s VA medical records, military service treatment records, and DD214 forms.
Supporting evidence, such as private medical records and a statement from the veteran or a “buddy letter” from someone else providing additional information about the veteran’s disability.
References to relevant medical research such as scientific studies and medical journal articles that support the author’s key points
A strong conclusion that definitively states, the disability is “at least as likely” due to the veteran’s military service
In addition to the above elements, make it short. It is often thought that a longer letter will increase the chances that a claim will be approved. This is not the case. VA raters review hundreds of letters per month, so a succinct, straightforward letter can help them make their decision quickly and with confidence.
Who Can Write a Nexus letter?
What Should You Do if Your Physician Won’t Write You a Nexus Letter?
What Should You Do If Your Claim Was Denied With Nexus Letter?
We are here to help, don’t give up the fight!
Get in touch with the Veterans Claim Servants team today to effectively establish the service connection for your condition and get you the benefit you deserve.
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