A high-quality, credible VA Nexus Letter written by a qualified medical professional is arguably #1 way for veterans to prove service-connection, aka, the “Nexus” requirement under the law.
Many veterans are denied service connection by the VA because they failed to show a clear nexus (logical link or connection) between a current disability and their active duty military service.
But regardless of how many times you’ve been denied service connection, there is still hope!
Enter the VA Nexus Letter.
What is a “Nexus” for a VA disability claim?
According to the VA, a “Nexus” is simply a logical link or connection between a veteran’s current disability and an in-service incident, event, or injury.
To be eligible for VA disability compensation benefits under the law, a veteran must prove that their disability was caused or made worse by their active duty military service.
Did you know that a VA Nexus Letter and an Independent Medical Opinion (IMO) are the SAME THING (the terms are sometimes used interchangeably)?
In our experience, a credible VA Nexus Letter is the single most crucial document a veteran can provide the C&P examiner and VA Rater to help prove service connection on an “at least as likely as not” basis.
Yep, a high-quality, credible Nexus Letter really is the single, most powerful way to prove service connection!
What is a VA Nexus Letter?
A VA Nexus Letter is an evidence-based document prepared by a competent and credible medical professional that helps to establish a “connection” between the veteran’s current disability and their active duty military service.
A VA Nexus Letter is often the “essential” piece of credible evidence needed to help a veteran get their VA disability condition service connected under the law.
WATCH: What is a Nexus Letter?
Why do I say this?
Because VA disability claims are won or lost because on MEDICAL EVIDENCE.
Either you have enough medical evidence or you don’t!
A great VA nexus letter IS medical evidence and can influence the C&P examiner’s medical opinion, as well as the VA Rating Official’s final disability decision, due to the medical nexus evidence provided in the letter.
4 Key Elements of a VA Nexus Letter
VA Nexus Letter Key #1: The doctor should list any supporting evidence reviewed
The nexus letter doctor should reference any medical or personnel records reviewed, such as service treatment records, VA medical records, private treatment records, DD 214, or any other existing evidence of record.
Medical Nexus Letter Key #2: The doctor must offer supporting, evidence-based rationale
The most credible VA nexus letters list medical research studies, scientific journals, or previous BVA case law precedent that describes the medical etiology of the veteran’s condition, and the relationship to the veteran’s military service.
This is especially important for direct service connection, secondary service connection, and presumptive service connection because medical etiology, also known as a “showing of causation,” is important to help a veteran prove service connection under the law.
VA Medical Nexus Letter Key #3: The doctor should give a strong medical nexus opinion
Make sure the medical professional writes one of five statements of likelihood in the VA nexus letter to help the veteran prove service connection under the law, preferably, the words “more likely than not.”
VA Nexus Letter Key #4: The doctor should list his/her credentials, such as job title and specialty
The doctor must sign and date their name, in addition to listing his/her medical credentials, such as, Oncologist, Orthopedic Surgeon, Sleep Specialist, PA-C, MD, etc.
This is a particularly important part of the VA nexus letter because it helps the VA Rating Official determine if it’s competent and credible for VA rating purposes.
The 5 Statements of Likelihood for a VA Nexus Letter
When asked to give an independent medical opinion as to whether a veteran’s condition is related to a specific incident during military service or another service-connected disability, the medical professional should express his/her medical nexus opinion with one of the following 5 statements of likelihood:
#1 “Is due to” (100% sure)
The VA nexus opinion “is due to” means the doctor is 100% certain that a veteran’s condition was caused or made worse by active duty service or by another service-connected disability for secondary service connection.
#2 “More likely than not” (greater than 50%)
The nexus opinion “more likely than not” means the doctor believes there is a greater than 50% chance that a veteran’s condition was caused or made worse by active duty service or by another service-connected disability for secondary service connection.
#3 “At least as likely as not” (equal to 50%)
The VA nexus letter opinion “at least as likely as not” means the doctor thinks there is an approximate even balance of medical evidence for and against, and thus, there is a 50/50 chance that a veteran’s condition was caused or made worse by active duty service or by another service-connected disability for secondary service connection.
This is the minimum nexus statement that will help a veteran prove service connection, because the Benefit of the Doubt always goes to the veteran according to VA law.
When all things are equal, tie goes to the veteran!
#4 “Less likely than not” (less than 50%)
The nexus opinion “less likely than not” means the doctor thinks there is a less than 50% chance that a veteran’s condition was caused or made worse by active duty service or by another service-connected disability for secondary service connection.
This statement will likely cause the VA Rater to deny service connection, unless one or more other medical opinions carry more weight (higher probative value) or contain different medical opinions.
#5 “Is not due to” (0% chance)
The nexus opinion “is not due to” means the doctor thinks there is a 0% chance that a veteran’s condition was caused or made worse by active duty service or by another service-connected disability for secondary service connection.
This statement will cause the VA Rater to deny service connection.
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About the Author
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).