A Nexus letter is an essential document, signed by a qualified medical professional, that establishes a crucial link between an in-service stressor and a current medical condition. To comprehend its significance, let’s delve into the three fundamental elements crucial for successful VA claims:

1. Current, Diagnosed Disability
2. In-service stressors (e.g., injury, illness, traumatic event)
3. Connection Linking Parts 1 and 2

The Nexus letter plays a pivotal role in achieving the critical third step—the service connection—in both initial claims and appeals cases. It can often be the deciding factor in whether a claim or appeal is granted. But what exactly is a nexus letter, what components does it encompass, and how does one obtain it? In this article, we will explore nexus letters in detail, addressing common questions and providing an example VA Nexus letter.

Key Components of a VA Nexus Letter:

A comprehensive VA nexus letter should comprise four crucial elements:

1. Medical Expertise: Authored by a medical expert specializing in the relevant medical condition. The letter should affirm that the author has thoroughly reviewed the claimant’s medical records, including the VA claims folder (C-file).
2. Evidence: In addition to the nexus letter, include supporting evidence such as buddy letters, prior medical records, and military service records that validate the disability.
3. Research Support: References to relevant studies in medical journals or other medical literature that support the conclusions made by the physician.
4. Conclusion: While an explicit recommendation is not mandatory, the nexus letter should determine whether the in-service stressor is “more likely than not” to have caused the current condition.

While these requirements may seem extensive, Nexus letters are typically concise, as exemplified by the sample Nexus letter provided later in this article.

Authorship of Nexus Letters:

Nexus letters must be authored by a medical expert, specifically a specialist related to the claimant’s medical condition. The specialization is crucial, as the VA considers credentials to assess the probative value of the nexus letter. Medical credentials enhance the credibility of the opinion, providing a stronger case than a general practitioner’s or family doctor’s statement.

Options if Your Physician Won’t Provide a Nexus Letter:

If your treating physician is unwilling or unable to write a Nexus letter, alternative options include seeking an independent medical examiner (IME), which Veterans Valor can assist with. We have available physicians who specialize in writing Nexus letters and have negotiated some of the lowest costs in the industry.

Common Questions About VA Nexus Letters:

To further clarify the importance and intricacies of Nexus letters, let’s address some frequently asked questions:

1. When Do You Need a Nexus Letter for VA Claims? Nexus letters are beneficial for most VA claims and appeals, especially for secondary service-connected claims and those not covered by presumptive conditions.
2. Can You Win an Appeal Without a Nexus Letter? While not guaranteed, a medical nexus letter can significantly increase the likelihood of a positive appeal outcome.
3. When Should You Submit Your Nexus Letter? Ideally, include your nexus letter with your initial VA claim. If your claim is denied, submit it with your appeal.

What to Do if Your VA Claim is Denied With a Nexus Letter:

A Nexus letter may enhance your claim, but it doesn’t guarantee success. In case of denial, don’t lose hope. A Notice of Disagreement (NOD) is a formal written communication expressing dissatisfaction with the Department of Veterans Affairs’ (VA) determination regarding a disability claim. This is in accordance with 38 CFR § 20.201, which defines a NOD as a written communication from a claimant or their representative expressing dissatisfaction or disagreement with an adjudicative decision by the agency of original jurisdiction. The process to file an NOD is initiated after receiving the decision letter from the VA. Under 38 CFR § 20.300, claimants are required to adhere to specific procedural guidelines to ensure the proper handling of their disagreement. Moreover, the introduction of the Appeals Modernization Act has significantly altered the NOD process, as outlined in 38 CFR §§ 19.2, 19.36-19.38, changing the framework for how veterans can contest VA decisions and seek reviews. Our expert claims advisors here at Veterans Valor can assist in this endeavor.