You’re confident you deserve a veteran disability pay increase, and you know enough about the VA to understand that you’ll need a letter tying your health condition to your military service. You find a physician, explain your situation, and get them to write a letter on your behalf. You’ve done the hard part…or so you think.
Then the denial comes.
The VA received your letter, but it didn’t change anything. What happened?
The answer is almost always in the letter itself. Without meeting specific requirements, your letter may lack the power to move the needle on your claim. That’s why you need to understand what separates a strong letter from a weak one.
What’s a Nexus Letter Anyway?
In order to approve a claim, the VA needs to see a “nexus,” or a connection between a veteran’s health condition and their military service. For example, a veteran’s tinnitus could be connected to their time on the flight line, where jet noise was the constant. Or a veteran’s neck and back problems may have developed due to the countless hours they spent hunched over airplane parts as an aircraft maintainer.
In some cases, this connection is explained clearly in the veteran’s military health record. Let’s say a veteran started to hear ringing or buzzing in their ears while they were still in the military and saw a doctor for the problem. The doctor documented this evidence of tinnitus in the veteran’s military health record. This veteran now has a strong “nexus” to base their rating on.
Unfortunately, there are many reasons that the veterans’ military health records don’t reflect their health problems:
- The veteran experienced a health problem while on active duty but failed to report it. They may have assumed the condition would go away on its own, or they may have thought that reporting the condition would make them seem like a complainer.
- The veteran may have reported their condition while on active duty, but their physician failed to document the condition in their medical records.
- The veteran’s medical records may have been misplaced.
- The veteran’s health condition didn’t manifest until years after they left the military.
Now, the burden of proof is on the veteran. They must prove that their condition is linked to their military service, even though their military records don’t reflect it. A nexus letter provides a way to do this. A nexus letter is an evidence-based letter written by a medical professional that shows the link between a veteran’s disability and their military service.
5 Ingredients of a Strong Nexus Letter
You want a nexus letter that makes your VA claim hard to deny. Here’s what makes a winning nexus letter.
1. The Right Specialist
If you are looking for a rating for depression, your letter is going to be more credible coming from a psychiatrist than a family practice doctor. In general, you want your letter to come from a physician who is the most highly trained in the specialty area that is most relevant to your disability.
2. The Right Verbiage
The VA is looking for very specific language. Consider these statements:
Letter A: “It’s possible that [John Doe’s] tinnitus is linked to his military service.”
Letter B: “It is more likely than not that [John Doe’s] tinnitus is linked to his military service.”
Letter B is going to carry more weight. The VA isn’t looking for a murky, hypothetical connection. They favor wording that shows that the connection is “more likely than not” or “at least as likely as not.”
In some cases, a physician may be willing to make a strong claim that your condition “is due to” your military service. This almost always leads to a claim approval, but most doctors aren’t willing to make this strong of a claim unless you can present very compelling evidence.
3. Evidence-based Rationale
A strong letter will include an explanation of the military “nexus” backed by medical evidence and research. For example, a doctor may explain how a veteran’s frequent deployments or duty shifts disrupted their circadian rhythms and contributed to their sleep apnea. They may even cite medical research that shows a link between combat deployments and sleep apnea.
4. Clear Organization
A nexus letter that jumps around, is repetitive, or is confusing will be less compelling than one with a clear format and structure.
5. Lack of Credentials/Contact Information
The letter should include the medical professional’s name, credentials, signature, and contact details (phone number, email, etc.).
How to Get a Nexus Letter That Works
Knowing what a strong nexus letter looks like is a good starting place, but getting a physician to write one that actually meets the VA’s standard is the thing that gets you across the finish line. And it’s where most veterans stumble.
Most doctors aren’t familiar with the VA’s specific language requirements. They’re medical experts, not VA experts. Unfortunately, a willing physician who uses the wrong phrasing can’t help you, no matter how strong the underlying medical case is.
VA Claims Academy helps close that gap. We provide you with nexus letter templates that you can present to your physician. It makes life easier for them because they don’t have to reinvent the wheel; they have a proven pattern to work off of.
If your physician will not write your letter, we can help you connect with nexus letter doctors who routinely write these letters for veterans.
We give you the resources you need to secure a nexus letter that is individualized, well-supported, and written in the language the VA responds to.