One of the most powerful tools you can include in your VA appeal—especially in 2025—is a nexus letter. This document can be the missing piece that connects your current medical condition to your military service. If your initial claim was denied due to lack of a clear connection, a nexus letter could dramatically improve your chances of approval during an appeal.
What Is a Nexus Letter?
A nexus letter is a written medical opinion from a licensed healthcare provider that directly links your current disability to your time in service. The word “nexus” means connection, and in VA terms, the letter serves as evidence of that connection.
It typically includes:
The medical provider’s credentials
A summary of your medical history
A statement that it is “at least as likely as not” that your condition is service-connected
A medical rationale explaining how your condition is related to your service
In 2025, with the VA becoming more strict about medical evidence, a well-written nexus letter is more important than ever.
Why Is It So Effective in Appeals?
Many initial claims are denied because the VA says there’s “no evidence of a connection to service.” A nexus letter fills that gap by providing professional medical support for your claim.
During appeals—especially Supplemental Claims or Board Appeals—you’re allowed to submit new evidence, which means a nexus letter can be used to reopen or strengthen your case.
In 2025, as claims involving conditions like sleep apnea, tinnitus, and mental health are being scrutinized more closely, nexus letters are especially important for:
Secondary service connections (e.g., sleep apnea caused by PTSD)
Conditions with delayed symptoms that didn’t appear immediately after service
Appeals of denied claims due to “insufficient medical linkage”
What Makes a Good Nexus Letter?
Not all letters carry the same weight. A strong nexus letter should:
Be written by a qualified medical provider (MD, DO, psychologist, or specialist)
Use VA-accepted language, such as “at least as likely as not”
Explain the reasoning behind the connection—don’t just make a statement
Be based on a review of your medical and service records
Be clear, professional, and medically sound
Avoid using providers who offer generic, one-size-fits-all letters that may not hold up during VA review.
How to Get a Nexus Letter
Ask your primary care doctor if they’re willing to write one
Contact a private provider who understands VA disability claims
Work with a veterans-focused consulting company that offers medical opinion services
Be prepared to pay—some doctors charge a fee for writing detailed medical opinions
Make sure the provider has access to your service records and medical history so they can support their opinion with evidence.
Final Thoughts
If your VA appeal hinges on proving a link between your condition and your service, a strong nexus letter might be the difference between approval and denial. In 2025, as the VA tightens standards on evidence, this one document could carry more weight than anything else you submit. Don’t underestimate its power—and don’t delay in securing one if you plan to file or appeal a claim.
