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. Nexus Letters are written by the veteran’s current physician(s) stating their medical opinion regarding the service-connection of a veteran’s condition(s). 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.
In the majority of these cases, there isn’t enough medical research to always support a claim. Under such circumstances, the only way to win a claim is to have very strong Nexus Letters.
Regardless of the type of claim, a Nexus Letter must contain four vital elements:
In more straightforward cases, a single Nexus Letter from a strong source (a specialist in the area in question) will be enough. However, on more complex cases, particularly ones without enough medical studies or evidence to support the connection, multiple Nexus Letters from different physicians could be beneficial. The more physicians who agree, the less room the VA has to disagree.
It is the veteran’s responsibility to do the ground work and obtain these Nexus Letters. The physicians writing them do NOT have to be related to the VA, however, ones familiar with the disability system may be more willing to write the letter.
It can take some work to find a physician with the right specialty and knowledge of your condition who would be willing to write a Nexus Letter. It’s best to start with the physicians that know you and your conditions the best. If they refuse to help, you may have to branch out and see others in your area. There is, unfortunately, not a database of doctors ready and willing to help with Nexus Letters.
If your doctor is hesitant, you might help them out by drafting one for them from our Sample Nexus Letter that they can simply review, adjust, and sign. Saving your doctor time and headache is always a solid way to get on their good side.
A Nexus Letter is a letter from your physician detailing the connection between your current conditions and your military service. The connection could be directly to a military event or circumstance, or to another medical condition that occurred in service.
If you have strong evidence that your conditions are service-connected, then you probably do not need a Nexus Letter. You definitely need a letter, however, if you are trying to prove that your condition is secondary to another service-connected condition or if you do not have strong proof of service-connection.
The physician who knows your current conditions the best should write your letter. Their opinion will hold the most sway since they thoroughly understand your conditions and history.
Often civilian physicians are a bit intimidated by the idea of writing a Nexus Letter simply because they are unfamiliar with the disability system. The best option after you meet with your physician is to send them a letter already written for them that they can then adjust as needed and sign. This helps them feel more confident and diminishes the amount of work they have to put in. If your physician still won't write the letter, you may need to seek out another physician.
A Nexus Letter is just like any other proof you may have for a claim. As such, it is very important to submit it right at the beginning along with your claim. Submitting it later could result in it not being considered or delaying your claim. If you obtained the letter after your claim was denied, you can submit it as new evidence along with your appeal.
Check out our sample letter for full details on the contents, but briefly, it should contain the doctor's name and credentials, the diagnosis and history of the condition, details on how the condition is connected to your military service, and a clear statement that the condition is 'more likely than not' the result of _________.
Yes, if you have multiple medical professionals who are familiar with your conditions, you can submit a letter from each of them. Multiple opinions in your favor definitely strengthen your case, but are not always essential.
While Nexus Letters can be helpful, they are not guarantees that the VA will grant your claim. If there is strong evidence that the condition could have developed in a way unrelated to your military service, then there simply may not be enough evidence in your favor. You could always try to appeal, submitting additional letters from other physicians along with evidence of medical research that support your claim.