The nexus, or link, between a veteran’s current disability and an in-service event is often the hardest element of service connection to prove. However, without a nexus, a veteran’s claim with the Veteran’s Administration (VA) won’t survive. How does a veteran prove this complicated, yet crucial element of service connection? The nexus letter. In fact, a well written nexus letter may be the single most important document that a veteran can have for evidence in support of their claim for VA disability benefits.
What is a nexus letter?
A nexus letter is a document that a doctor or other medical professional prepares for a veteran, and it explains that the veteran’s current medical condition is related to their military service. A veteran is not required to submit a nexus letter in connection with their disability claim, but the nexus letter can sometimes make the difference between an award and a denial. Also, there is not a specific requirement of when a nexus letter can be submitted. A veteran can submit a nexus letter with their initial application for benefits, during development of their claim, or after an adverse C&P Exam. However, it’s good practice to submit a nexus letter earlier rather than later. The nexus letter becomes especially important in cases where a veteran has not submitted any medical evidence in support of their claim, and then a C&P examiner concludes that there is no connection between the veteran’s disability and military service.
Doctor’s opinions, especially in the form of a nexus letter, can be a very valuable tool in a disability claim if they are done correctly. Make sure to communicate with the doctor writing the nexus letter about all of the details the letter should include. A good nexus letter uses specific language, includes specific phrases, and ties the facts together to draw a conclusion about connection to service. Terminology can be very important in the nexus letter. Many doctors are not familiar with the VA system and VA standards; instead, they are familiar with the concept of “medical certainty.” Medical certainty is a much higher standard than the VA requires. In order to avoid a situation where the doctor applies the wrong standard, make sure the VA terminology is explained to them. For example, the terms “more likely than not” should be used to express that there is a 50% likelihood that the veteran’s current disability is related to his service. Using other terms may lead the VA to misunderstand the opinion as not supporting service connection.
It is also important to note that a doctor should mention in their letter that they have reviewed the veteran’s entire file and medical records. Failure to do this can result in the VA disregarding the doctor’s opinion.
When choosing a doctor to provide a nexus letter, start with the doctors that are currently treating you, or have recently been treating you. The VA does not require this, but oftentimes a treating doctor will have a better understanding of your conditions, and the history behind them.
Keep in Mind
In summary, here are 5 things that make for a stronger nexus letter:
- Keep the letter brief, but still complete. Do so by focusing on facts and conclusions.
- Use a doctor who is board certified in the area of health that is at issue.
- Make sure the doctor has access to your relevant medical records and service. Have the doctor state in the letter that they had access to, and were able to review these records.
- The doctor’s opinion does not have to be absolute. Remember to inform the doctor that they just need to point out whether “it is as least as likely as not” that the current condition was caused by an even during service.
- While not required, using a doctor that has recently examined the veteran can add weight to the nexus letter.
Keep in mind that, the doctor who agrees to write a nexus letter is a neutral party. As a neutral party they are supposed to provide an honest opinion based on their review of the evidence presented to them. The doctor is not required, or obligated, to agree with the veteran