Nexus Letter

About the Nexus Letter

The nexus letter is one of the most important aspects of your VA claim for benefits, as it is the key source of data linking your present condition to your active service, which provides the foundation for the approval of your benefits. Without an effective nexus letter, your initial application could be rejected, leading to years worth of appeals to receive your benefits. In some situations, a poor nexus letter could prevent you from being eligible to receive VA benefits at all. 

While a nexus letter is absolutely essential to the success of your VA disability claim, it is not always easy to get an effective one. 

To acquire an effective nexus letter, it is first necessary that you find a doctor with the proper knowledge and skills to address all the requirements of the VA in your application process. Ideally, this doctor would charge you a reasonable flat fee; however, that level of expertise on its own can be especially costly. Working with an experienced VA disability lawyer in your area is particularly valuable, as often your attorney will be able to front the cost of a nexus letter for you.

The Key Information About Nexus Letters 

When it comes to your VA disability application, the phrase “nexus” is defined by the VA as “causation”. It is the linking evidence between service and your current disability.  When you apply for your VA benefits, you need to provide a medical opinion that states that your disability is a result of your time during qualifying active service. The medical opinion is then written up in the form of a nexus letter.  Although it is often called a nexus letter, it is really an expert medical report.

Doctors who have the ability to determine your condition do not necessarily know how to draft nexus letters that will conform to the requirements and expectations of the VA. Throughout the process of your claim, the VA has a “duty to assist”, which means that the VA has a requirement to help veterans acquire a medical opinion in support of their claim. 

Once you’ve taken the time to submit your claim to the VA, the VA has the option to request that you undergo a Compensation and Pension Exam (C&P Exam). Within the C&P Exam, a medical doctor, or in some instances a VA nurse practitioner, will perform a basic physical examination. They will also review your medical records to determine and verify if the disability you are claiming is linked to your service. Within some C&P Exams, a complete examination is not even completed, but instead you are simply asked questions that are then entered into a computer. 

In the event that the basic C&P exam conducted by the VA doctor or nurse practitioner is not conclusive, they may order additional tests such as labs, x-rays, and so on. Upon completion of your C&P Exam, the VA medical professional drafts a C&P Exam report which is then transmitted to the VA claims adjudicator for them to process. Oftentimes a veteran is not provided with a copy of the C&P Exam report, however it is placed into your claim file and considered. 

It is important that veterans take advantage of their right to demand a copy of the C&P Exam report. In this way, you have the ability to respond to any potentially unfavorable exam reports before the VA makes a final decision. When you work with an experienced VA disability benefits law firm, you have the benefit of a legal expert in VA disability claims reviewing your C&P Exam report. 

The attorneys from your VA disability law firm, if you have one, will assist you through the process of obtaining your C&P Exam report. If veterans hire us to conduct a nexus letter analysis, we’ll review it, and will provide a response to the VA exam report. More often than not, the way to reply to the VA’s unfavorable C&P Exam is by submitting a rebuttal nexus letter that we help you refute the negative medical opinion that resulted from the VA C&P examiner. 

You might wonder whether or not the VA’s own medical professionals, who are not always doctors and do not always perform extensive exams, have your best interests in mind. The fact of the matter is, these professionals are often overworked with a gigantic caseload, and your claim may not receive the care and attention it deserves to result in your getting the full benefits you are entitled to. But most often, the VA’s doctors are biased in favor of VA.

Do VA Doctors and Nurse Practitioners Write Nexus Letters for Veterans? 

The C&P Exam report that is submitted to the VA analysts for review by the VA medical professionals basically serves as the nexus letter for your claim if you do not produce and provide your own. It is important to remember that in this instance, the party responsible for paying you, the VA, is effectively hiring their own doctor to provide evidence in your claim. The VA has stringent guidelines on which claims can be approved, as the VA has a set budget, and must only approve those claims that meet these high standards. VA doctors may not have sufficient time or expertise to adequately assess your health and current condition, or to extensively review your medical records. 

C&P Exam doctors and medical professionals work for the VA, and understand the objectives of the VA. In effect, the C&P Exam doctors and medical professionals serve as gatekeepers in your efforts to acquire VA disability benefits. 

Providing an Independent Medical Opinion is Best 

While you could process your VA disability claim entirely through the VA with the assistance of VA-accredited representatives and medical professionals through a C&P Exam, an independent opinion is best. By taking the proactive step of getting your own nexus letter, the success of your claim is best supported. 

Getting your own nexus letter means that you’ll need to find a private doctor capable of writing you an objective, and unbiased nexus letter. It is essential to underline the fact that a nexus letter is not simply a “letter”, but a complex piece of medical evidence that does the following: 

  • Establish a clear and sufficient diagnosis of the current condition for which you are applying for VA disability benefits concerning, whether depression, cancer, a worsened condition that you’ve already got a VA disability rating on, etc.
  • Clearly link your current condition or diagnosis to an event, injury, or illness that you experienced during qualifying active duty

Not all medical experts are familiar with how to write a nexus letter, so it is helpful to know how to find one. 

Finding a Doctor to Write a VA Disability Letter 

One of the most effective ways of finding a medical professional is by reaching out to a local veterans’ disability attorney. They have a network of medical professionals capable of providing you with the kind of nexus letter that will best support your VA disability claim.  The other option for the do-it-yourself claimant is to search out medical consulting firms or try to ask their treating doctor for a letter.

While some local VA disability benefits attorneys may be willing to share their network with you for help on your initial claim, the examinations can be costly. In certain situations, namely appeals and supplemental claims, a VA disability attorney is able to take over your claim, and will cover all related expenses and only be paid if they win. 

When to Contact a VA Disability Benefits Lawyer 

VA-accredited attorneys cannot take fees to assist in your initial VA disability application, which is why it is important that you obtain an independent nexus letter in support of your claim instead of relying entirely and exclusively upon the VA throughout the process. 

There are two instances where a VA disability lawyer can help: 

  • To help you appeal an adverse decision from the VA concerning your VA disability application. 
  • For help with a supplemental claim, for (1) appeals of denials; or (2) to reopen a previously denied claim that was denied more than 1 year earlier. 

In these instances, if your VA disability attorney is able to take your case, they’ll only be paid if they win on your behalf. Veterans disability cases are taken on contingency, and the attorney award comes out a portion of the back-pay you are owed. 

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