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. 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.
What does a "Nexus" Letter Say:
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. 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. In order to avoid a situation where the doctor applies the wrong standard, make sure the VA terminology is explained to them, or use the blank example we provided as a template.
6 TIPS ON A SUCCESSFUL NEXUS LETTER:
1) Keep the letter brief, but still complete. Do so by focusing on facts and conclusions.
2) Use a doctor who is board certified in the area of health that is at issue (Ex: Pulmonologist for a lung issue or a Neurologist for a TBI)
3) Make sure the doctor has access to your relevant medical records and service (Bring your "I Love Me" Binder)
4) Have the doctor state in the letter that they had access to, and were able to review these records.
5) 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.
6) While not required, using a doctor that has recently examined the veteran can add weight to the nexus letter (I had my orthopedic surgeon write mine, she knew me very well)