In a previous blog, I touched on the importance of a Nexus, or bridge, in connecting a disability to service. Here, I will discuss the importance of how to make sure the nexus letter is in the best possible favor for a veteran.
A claim for a Veterans Benefits Administration (VBA) disability compensation award should decisively be based on irrefutable evidence. If the claim leaves any inkling of doubt in the mind of the ratings specialist making the award decision, a veteran may be denied. Often, this is the case when the veteran alleges that an injury or illness having occurred in service has worsened over the years. While the condition may have been relatively minor then, it’s significantly debilitating today.
To show that there exists a connection between his/her documented service event (wounding, illness) and a condition today (cancer, worsening of original injury, etc.) requires that the veteran present a favorable opinion of an expert who agrees with his/her thought process. This is known as a nexus letter. In layman’s terms, the definition of nexus is bridge, connection or interconnection.
When writing a nexus letter, a few points to remember are in order.
- The letter should be as clear and concise as possible while also stating facts.
- The author must be an expert. This is most often a medical doctor who is board certified in the area of health or disability that’s at issue.
- The expert who signs the nexus letter must have thoroughly reviewed all available and pertinent medical records (to include Service Medical Records) and illustrate that fact in the letter. The letter won’t be of much value if the expert can’t reasonably verify that all records were reviewed.
- The nexus letter should be as detailed and accurate as the circumstances allow.
Although it may not always be a requirement, it will lend a lot of credence if the veteran has been recently examined by the writer of the nexus letter. The medical expert who authors the letter does not have to use absolutes or conclusions in his or her statements. Opinions are based on conjecture of observing facts and circumstances arising from those facts. The optimal language to describe an expert’s opinion should express whether “it is more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability less than 50 percent) that the illness and/or injury was incurred or aggravated during active service.
The take away from all of this is a well written nexus letter is an extremely powerful tool for the veteran to use to establish a claim. Often the VA will recognize that the doctor who writes a veteran’s nexus letter is better trained, better experienced, or spent more time examining the veteran than a VA Compensation and Pension (C&P) examiner did. In many cases at the VARO level as well as the Veterans Board of Appeals, the expert opinion expressed in a nexus letter has been the deciding factor that wins a veteran his/her well earned benefits.