NEXUS Letter

A NEXUS letter is a key element in filing a claim to access benefits for service-related disabilities. The NEXUS letter is a written medical opinion by a qualified medical provider specifically regarding the veteran’s injury/disability in question. Most of the time, the evaluating doctor will complete the NEXUS letter, however, sometimes the veteran must do it. There must be significant proof to get a successful VA claim these days (as there has always been). Just a tip:

The evaluator’s job is NOT to just look at your condition and say “Okay, it’s a legitimate service-connected disability.” Their job is to determine whether or not the injuries are service related, and try to prove that they aren’t more than anything.

What Is a NEXUS Letter?

The NEXUS letter is a way of linking your injury to your VA or medical claim. A NEXUS letter should be written by a veteran’s primary care physician stating their medical opinion regarding whether the claim was service connected or not. What a lot of veterans don’t know, is that they are required in order to get a VA disability claim, especially one that’s not originally thought of to be service-connected. This way there’s enough evidence to show that your injury is indeed service related and that your injuries are also on the VA’s Presumptive List.

Why Only One NEXUS Letter?

All conditions, and even secondary conditions, need a separate NEXUS letter. Only one letter is allowable for each claim, however over time, you may be able to prove that a condition caused by a service related injury (even one that’s gotten worse and is eligible for a disability increase claim to be filed) has indeed gotten worse simply because of the original disability. These secondary claims are conveniently named “secondary conditions.” For example, if you had a knee injury in the military, and you end up with hip problems because of your knees, or if they are irreparable, then you may be able to file a secondary condition claim, and that would need its own NEXUS letter. Or for example, if someone whose military-related injury isn’t resolved and they later get arthritis because of it – this is considered a service-connected secondary condition.

How Can I Make Sure My NEXUS Letter is a Great One?

This is something every veteran needs to think about when handling a VA claim – whether it’s an initial claim or an increase claim. There are many factors that can help in terms of ensuring you get your claim processed properly. This checklist will help get a good NEXUS letter (and while only one is generally accepted, you can have your primary care physician send this letter as well). We haven’t met anyone who’s gone through the VA system and praised their VA assessor. As we said earlier, their job is to NOT believe you. However, if your primary physician has more proof compared to the VA’s assessing doctor, you can boost your chances of success by using their medical mentions. But only if they know every detail about your condition, claim, and have seen every single bit of your medical records (including the VA records). Do note, however, that your primary care physician must be credible. Of course, the VA likes it when they’re a dedicated VA doctor.

Keep in mind that your NEXUS letter should contain certain criteria to have a solid case, and you can get an even better letter written if you make sure these things are done as well:

1. The letter should be brief but have all information necessary on the facts of the case and the conclusions from the doctor.
2. You can have a doctor who specializes in your area of injury perform the NEXUS letter. For example, have a primary care podiatrist write the letter for injuries with your knees/feet, etc.
3. Make sure your doctor has all records necessary to build your case. This may include medical records from while you were in-service. If you can’t find these, contact the National Personnel Records Center and request any records from your time in service. They have all military records from literally every database and their information can help. This may mean you have a wait on your hands though.
4. Your doctor doesn’t have to be 100% certain. If the doctor can at least declare in the letter that they believe the injury presumably happened during service, this can help your case.
5. Use the most recent doctor you’ve visited for your injuries. This isn’t required but will have a greater impact on adding success to your claim.

See an example of a NEXUS Letter at nd.gov.

Remember – If You Want Something Done Right…

One of the main phrases we’ve always heard when it comes to being squared away while in service, or even once we’ve done our time, is that “if you want something done right, then do it yourself.” The government has a lot of room for error, especially when it comes to the military – from documentation, to order requests, wrong information in the system, and of course, TRADOC.

Therefore, to get the most out of your NEXUS letter, you’re going to need to cover a lot of ground yourself to get it done right. Believe it or not, the first time many veterans file a claim, they are denied, and it’s not done to spite you – it’s simply because the VA doesn’t get enough information or an official diagnosis (this truly is the most common reason people get denied). Similar to trying to get a home loan when you have no credit – you need to have a tiny bit of credit (good) to get a loan right? So do your paperwork for your records and keep them all on file where you can access them easily. Use all of this information to your advantage when you file your claim, and to prepare your NEXUS letter. Go get ‘em!

Justin Williams is a certified Microsoft Specialist and U.S. Army Veteran. Serving in 2008, he was a Multichannel Transmission Systems Operator with the 15th Signal Brigade. After an Honorable Discharge, he struggled to get access to military benefits for service-related injuries. Justin has committed to helping other veterans navigate the system and get the most out of their hard-earned veteran status.