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February 13, 2024

Do I Need a Nexus Letter for Presumptive Conditions?

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No, you don’t need a Nexus Letter for presumptive conditions.


Because a presumptive disability condition does not have a specific “Nexus” requirement under the law.

In fact, the VA “presumes” your disability is automatically connected to your military service, assuming you meet the other requirements for presumptive service connection.

Okay, let’s explore VA presumptive conditions in more detail.

What is a VA Presumptive Disability?

What is a VA Presumptive Disability

A VA presumptive disability is one that the VA “presumes” to be service connected, even if there’s no specific “Nexus” for service connection.

Here’s how presumptive disability works:

If you served at X location during the qualifying period and developed Y condition as a result, then X + Y = automatic service connection.

Instead of having to prove a service-connected disability, you only need to show on your DD 214 that you were in an eligible location during a specific period and that you developed a qualifying condition as a result.

We also recommend you write and submit a strong personal Statement in Support of a Claim.

Buddy letters can also be helpful in filling in any gaps in service or personnel records; make sure your buddy statements are from first-hand witnesses.

>> Click HERE to see a list of over 200 VA presumptive disability conditions

What are the VA Presumptive Eligibility Requirements?

For certain disability conditions, the VA automatically assumes (“presumes”) that your military service caused your condition.

If you have a presumptive VA disability condition, you don’t need to prove that your service caused the condition.

You only need to meet the service requirements for presumption.

Find out more about the basic categories and to check your eligibility for presumptive disability:

Do I Need a Nexus Letter for Presumptive Conditions?

No, Nexus Letters are not necessary for presumptive VA disability.


Because presumptive disabilities do not have a specific “Nexus” requirement under the law.

The VA “presumes” your disability is automatically connected to your military service, assuming you meet the other requirements for presumptive service connection.

What is the VA Regulation on Presumptive Service Connection?

According to the VA’s M21-1, “Diseases or conditions subject to presumptive service connection will be considered to have been incurred in or aggravated by service if manifested to a compensable level, when required by the corresponding regulation or statute, within the time frame specified for that certain disease under the regulation or statute, even if there is no evidence of such disease during service.”

Translation: A specific “Nexus” is not required to prove presumptive disability.

Here’s a helpful table of presumptive diseases or conditions as well as the appropriate references:

Type of Presumptive VA Disease or ConditionReference for Presumption of Service Connection
Chronic diseases38 CFR 3.309(a)
Diseases associated with service of the following categories tropical former prisoner of war exposure to radiation exposure to certain herbicide agents, or exposure to contaminants in the water supply at Camp Lejeune38 CFR 3.309(b)-(f)
Diseases associated with exposure to ionizing radiation38 CFR 3.311
Diseases based on full-body exposure to mustard gas or Lewisite38 CFR 3.316
Diseases associated with service in the Southwest Asia theater of operations including undiagnosed illnesses medically unexplained chronic multi-symptom illnesses, and certain infectious diseases38 CFR 3.317
Diseases associated with service in Afghanistan38 CFR 3.317(c)(2)
Amyotrophic lateral sclerosis (ALS) with at least 90 days of continuous active service38 CFR 3.318
Coronavirus disease (COVID-19)38 U.S.C. 1164
Diseases associated with exposure to fine particulate matter38 CFR 3.320

About the Author

Brian Reese
Brian Reese

Brian Reese

Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).

Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start. 

As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.

He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).

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