These Types of Doctors Can Write a Nexus Letter

March 4, 2024
Elite Medical Review Associates

If you believe you are entitled to disability benefits through the Department of Veterans Affairs (VA), you might need a nexus letter in order for your claim to be successful. These letters from a medical professional not only document your disability but also link it to an event in your past service history. The VA will not award benefits without this connection.

 Finding a doctor who can write a letter for your VA disability claim might be more difficult than you realize. The good news is that you do not have to track them down on your own. Elite Medical Review Associates has extensive connections with medical care providers that might be able to assist you.

General Practitioners Might Help

The first place most people look for help is from their general practitioner—assuming they have one (the treating doctor). While a family physician might be able to help with a nexus letter, the chances are good that they have limited experience with navigating the VA disability system. This is true of MDs and DOs. There are numerous doctors who will provide you with a diagnosis of your condition but might be unwilling or unable to provide you with a nexus letter.  In our experience, regular treating doctors are reluctant to get involved in any matters that relate to the legal system.  Moreover, they are often far too busy seeing patients to sit down and write an extensive nexus letter report.  And even if they do take the time to write something, they often write poorly and use speculative language.  They may have an irrational fear of being dragged into court.

One of the challenges that many veterans face is that they receive all of their medical care from the VA. Although the VA is required to assist with disability claims, the duty to assist often means that VA obtains a C&P exam report that is unfavorable to your claim. These doctors and nurse practitioners might do little more than ask a few questions and then come to a conclusion that your condition is unrelated to your service.

Unfortunately, finding a doctor who not only is willing to provide a letter but also has the experience with the VA needed to reach a compelling conclusion can be hard to come by. These are the veterans that are often most in need of help connecting with the right medical professionals.

Specialists Can Play an Important Role

Often, the most impactful letter comes from a medical professional who specializes in treating your disabling condition. They are often in the best position to explain to a VA claims decision-maker how they came to an informed conclusion on a link between your military service and the disability you currently live with.

 Countless specialists could be useful for this purpose. A psychiatrist might be able to show that your PTSD is linked to a traumatic event during active duty. An audiologist could tie your hearing loss or tinnitus to loud explosions in combat. Your podiatrist could provide invaluable details on how your leg or foot injury is the result of a training exercise gone wrong.  But often getting one of the treating specialists to write something is not always possible.

In addition, if you have multiple disabilities involving different body parts or systems, it would be too costly to obtain a specialist for each.  In those cases, it is most economical to go with a doctor who has broad experience in multiple specialties and who feels comfortable writing on multiple conditions.

You Might Not Need a Doctor at All

While many people rely on the support of a physician when pursuing VA disability benefits, you might be surprised to learn that there are other healthcare professionals who might be able to help.

It is possible that a physician’s assistant could provide you with a nexus letter. These medical professionals are not doctors, but they follow a similar training path. They can generally practice medicine in a limited setting, and they have more training than a nurse.

Speaking of nurses, you might also have luck seeking the help of a nurse practitioner. These individuals have graduate degrees in nursing, and their extensive training allows them to work independently in limited scenarios. An NP could provide you with the documentation you need.

In general, anyone with medical training could potentially write a nexus letter, but their relative qualifications and strength of their credentials would affect the evidentiary weight that VA may place on the nexus opinion.  M.D’s cost more than reports from non-M.D. healthcare professionals, but their opinions would carry more weight.  When analyzing what to do, all these factors must be considered.  Generally, you want to obtain the best opinion you can for what you can afford.  

Nexus Letter Doctor FAQs

Do I Need a Nexus Letter?

Some veterans are able to secure benefits without a nexus letter from a doctor detailing the link between their medical condition and their service. In fact, there are certain situations where a service connection is presumed. For everyone else, having a letter from a medical professional could be important.

In fact, some people might ultimately need two distinct letters. It is not unusual for someone seeking VA benefits to suffer from two or more unique conditions. For example, they might have both a physical ailment and a mental health issue that impacts them. In that scenario, it might be best to have a letter for each of these conditions.

How Much Do They Cost?

The cost of a VA nexus letter can vary substantially across the country. While your geographic region will play a part in determining what it might cost, there are other factors to be aware of as well. These include the complexity of the case, the need for an opinion from a specialist, and the size of your case file.  The general rule is that you get what you pay for.  A cheap report will often be written by a non-M.D. and carry less evidentiary weight.  But if that is all you can afford, then it is better than nothing at all.  A good medical nexus report from a qualified M.D. is generally in the range of $1,500 to $2,500.  Psychological reports may be slightly more if extensive testing and evaluation is required.  Nexus letter reports by non-M.D clinicians could be less than $1,500 and some perhaps slightly less than $1,000.  Under no circumstances should a veteran retain a doctor to write a nexus letter based on a contingency fee for a percentage of the back pay.  That is a fee arrangement that is for lawyers who manage the entire case for you, and not simply for a doctor writing a report, which is just one small aspect of the case.  In addition, another common practice amongst expert witnesses is to take an upfront retainer and then bill against that retainer on an hourly basis.  Experts who utilize that fee arrangement typically require $5,000 upfront and then bill you at $500 to $700 per hour.  This can get very costly if your file is large.  We don’t recommend hiring a nexus letter doctor on an hourly basis.  At Elite Medical Review Associates, we utilize the flat fee approach.  This provides predictability for the veteran.

Will This Guarantee My Claim is Accepted?

There are never any guarantees when it comes to VA disability benefit claims. While we can connect you with medical professionals who will put you in the best position to be successful, the reality is that the final decision is made by the VA.

 It is also important to consider that service connection is only one aspect of a successful claim. The VA decision-maker could acknowledge the facts set out in the letter but disagree that your condition qualifies as a disability at all. While nothing is certain, we will work tirelessly to give you the best chance for a successful claim.

Let Elite Medical Review Associates Link You With Doctors Who Can Write a Nexus Letter

Whether you are filing a claim for the first time or dealing with the frustration of a denial, you deserve support that will answer your questions and point you in the right direction. If you are concerned that the lack of a VA nexus letter negatively impacted the outcome of your case, now is the time to seek help.

Let Elite Medical Review Associates answer your questions about securing an appropriate letter from a doctor, nurse, or other medical professional. Contact us as soon as possible to learn about your options. 

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