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If you’re a veteran fighting to get the VA disability benefits you’ve earned, one of the most powerful tools in your arsenal is a high-quality, evidence-based Nexus Letter—and I’m here to help you get it right the first time.
A Nexus Letter is often THE LINCHPIN to prove the connection between your current disability and your military service or another service-connected condition for secondary VA claims.
It can literally make or break your VA disability claim.
Without it, many veterans face frustrating delays, lowball ratings, or outright denials of service-connected benefits from the VA.
But with a strong, evidence-based Nexus Letter from a qualified expert independent medical professional, you can potentially unlock the VA disability benefits you deserve, faster.
In this article, VA disability expert Brian Reese provides veterans with an easy-to-use, downloadable Nexus Letter Template that’s been carefully crafted to meet the VA’s standards.
Whether you’re filing your first claim, appealing a denial, or adding a secondary condition, this template for Nexus Letters provides the framework your doctor needs to build a rock-solid independent medical opinion and nexus statement to support your VA claim.
Let’s begin!
Table of Contents
Summary of Key Points
- The Importance of a Nexus Letter in VA Disability Claims: A Nexus Letter is a vital piece of evidence for VA disability claims, often serving as the deciding factor in proving the connection between a veteran’s condition and military service. It can establish direct service connection, secondary conditions, or aggravation, making it an essential tool for winning claims, especially in cases of denials or low ratings.
- Key Components of a High-Quality Nexus Letter: A high-quality Nexus Letter must be detailed, factual, and evidence-based. It should include the medical provider’s qualifications, a list of records reviewed, and a clear rationale backed by medical studies, VA regulations, and past BVA decisions. The use of VA-approved language, such as “at least as likely as not,” is crucial to meeting the VA’s evidentiary standard.
- Who Can Write a Nexus Letter for VA Claims: Only licensed medical professionals with relevant expertise, including MDs, DOs, NPs, and specialists, can write Nexus Letters. These letters should explain the diagnosis, outline symptom continuity, and include diagnostic tests and imaging to strengthen the claim. Providers must also document secondary connections when applicable and reference VA laws and precedents.
- Pro Tips for Your Nexus Letter: Obtaining a Nexus Letter requires careful planning, and you’ll need to spend some money to get one. Veterans should select a qualified provider who is also a VA disability medical expert, include their CV, and attach all supporting evidence to establish credibility. Upload your Nexus Letter at claim submission, tracking its progress, and verifying that it was considered during the claims process are critical steps to ensure success.
What is a Nexus Letter?
A Nexus Letter is a critical piece of evidence used in VA disability claims to establish a connection, or “nexus,” between a veteran’s current medical condition and their military service.
This document is prepared by a licensed medical professional and serves as an advisory opinion supporting the veteran’s claim for direct service connection, secondary service connection, or service connection by aggravation.
Why is a Nexus Letter So Important for VA Disability Claims?
Without a strong Nexus Letter, many VA disability claims are denied due to a lack of medical evidence linking the condition to military service.
The VA operates under the principle of reasonable doubt—if the evidence is equally balanced, the veteran wins.
Thus, if the evidence is in equipoise, the VA is legally required to rule in your favor under the Benefit of the Doubt Doctrine (38 U.S.C. § 5107(b)).
And a well-written Nexus Letter can tip the scales in the veteran’s favor.
Pro Tip: Not all Nexus Letters are created equal. The VA assigns more weight to Nexus Letters with high probative value—those that are detailed, factual, and evidence-based.
Who Can Write a Nexus Letter for a VA Disability Claim?
A Nexus Letter must come from a licensed medical professional with expertise in the condition being claimed.
This includes:
- Nurse Practitioners (NP)
- Physician Assistants (PA)
- Psychologists or Psychiatrists (for mental health claims)
- Medical Doctors (MD)
- MD Specialists such as Orthopedists, Neurologists, or Cardiologists
Pro Tip: The provider should thoroughly review the veteran’s entire medical history, military service records, any service-related incidents, current medical research, and previous BVA decisions to build a compelling, evidence-based independent medical opinion.
What Makes a Nexus Letter High-Quality and Effective?
For a Nexus Letter to carry significant weight with the VA, it should be:
Detailed and Factual:
- Lists all medical records reviewed, demonstrating thoroughness.
- Provides a clear and logical rationale based on the veteran’s medical history.
Evidence-Based:
- Cites relevant medical research and studies.
- References past BVA decisions, if applicable.
Credible and Professional:
- Clearly outlines the medical provider’s qualifications and expertise.
- Includes the provider’s name, title, contact information, and signature.
Use of VA-Approved Language:
- At a minimum, phrases like “at least as likely as not” (50/50 probability) to help establish the required standard for service connection.
- “more likely than not” means greater than 50% probability.
Pro Tips for Submitting a Winning Nexus Letter
Choose a Qualified Medical Provider:
- Ensure the provider has relevant credentials (MD, DO, PA, NP, or PhD) and expertise in the condition being claimed.
- Highlight their experience and specialty in the Nexus Letter.
Include Provider’s Curriculum Vitae (CV):
- It’s a good idea to attach the provider’s CV to establish credibility and expertise.
List All Relevant Records Reviewed:
- Specify every relevant medical record, test result, and document reviewed to demonstrate thorough evaluation.
Make or Confirm a Medical Diagnosis:
- Confirm the condition with the correct ICD-10 code and describe the diagnosis clearly.
Explain the Evidence-Based Rationale:
- Offer a detailed and evidence-based explanation connecting the condition to military service.
- Use medical studies, guidelines, or peer-reviewed research to support the opinion.
Address Secondary Conditions:
- If the condition is secondary, explicitly state and explain the link between the new secondary condition and the service-connected condition along with appropriate rationale.
Cite VA Regulations and Case Law:
- Reference 38 CFR and BVA decisions that support the connection for added credibility.
Highlight Symptom Continuity:
- Emphasize the veteran’s current severity of symptoms and treatments that have continued post military service to prove chronicity and continuity of symptomatology.
Include Diagnostic Tests and Imaging:
- Attach evidence like MRIs, X-rays, or lab results that validate the diagnosis and severity of the condition.
Be Clear and Concise:
- Avoid vague language.
- The letter should be specific, factual, and professional without unnecessary details.
- Shorter is better than longer as VA claims adjudicators are extremely busy.
Include Provider’s Signature and Contact Information:
- Ensure the provider signs the letter and includes their full name, credentials, license number, and contact information.
Provide Enclosures and References:
- Attach any supporting documents, research studies, or cited sources referenced in the letter.
Submit Your Nexus Letter Early and Track Progress:
- Upload and submit the Nexus Letter at claim submission and track the VA’s receipt and processing of the evidence.
- Review your VA rating decision letter to ensure the Nexus Letter was reviewed and considered as evidence to support your VA claim.
Free Nexus Letter Template (Editable Download)
Click the link or button below to download an editable Nexus Letter Template in MS Word that’s been carefully crafted to meet the VA’s standards.
Note: This is an example only and your doctor or other private healthcare provider will need to edit the letter for your specific situation.
Conclusion & Wrap-Up
A well-crafted, evidence-based Nexus Letter can be the difference between winning and losing your VA disability claim.
It bridges the gap between your current diagnosis and your time in service, providing the evidence the VA needs to grant your benefits.
If you’re sick and tired of struggling alone to get the VA benefits you deserve, we got your six!
At VA Claims Insider, we specialize in helping veterans get service-connected fast—no matter how complex your case.
Ready to get started?
Call us today at 737-295-2226 for expert-level VA claim help!
Looking for a Nexus Letter to Support Your VA Disability Claim?
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About the Author
Brian Reese
Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.
A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.
Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.
