This blog addresses frequently asked questions about nexus letters, highlighting their significance and role in the VA claims process. By the conclusion, you will have a clear understanding of how to obtain and submit a nexus letter for your VA claim.
What is a Nexus Letter?
A nexus letter is a formal letter written by a healthcare professional that establishes a clear link between a veteran’s current medical condition and their military service, or another service connected condition. The term “nexus” refers to a connection or link between two things—in this context, it’s the connection between military service and a service-related event or injury in service.
This letter serves as evidence in supporting a veteran’s VA disability claim. It provides a detailed, evidence-based explanation, outlining the reasons behind their professional medical opinion.
A quality nexus letter can play a decisive role in the outcome of a claim, helping to strengthen the case that the condition is service-connected. For many veterans, it can be the determining factor in receiving disability benefits.
Who Can Write a Nexus Letter?
When it comes to getting a nexus letter, any licensed medical provider can write one. However, the VA prefers letters written by professionals such as medical doctors, doctors of osteopathy, physician assistants, nurse practitioners, or psychologists with a Ph.D. This group includes your private healthcare providers and specialists.
That said, not every provider is familiar with the VA claims process. It’s important to work with someone who understands military service, has solid medical experience, and knows VA requirements inside and out. Their credibility and willingness to support your case can make a big difference.
Here’s a quick guide to your options:
• Private Physicians: Often the best choice because they’re usually available and familiar with your medical history.
• Specialists: Ideal for conditions that need a focused level of expertise.
• VA Doctors: Generally, these aren’t recommended since they often perceive a conflict of interest or might be directed by their leadership not to write medical opinions for disability claims.
• Medical Expert Consultants: That’s where we come in. At Valor 4 Vet, we specialize in the VA nexus letter process and have been helping veterans since 2015.
If your claim involves mental health issues, be sure to check out our detailed article on mental health claims and nexus letters for more guidance.
Can a Veteran Write a Letter for Their Own Disability Claim?
A veteran can legally write and submit their own statement about their condition, but it’s important to know that this isn’t the same as a nexus letter. Your personal statement can describe the symptoms you’re experiencing and how they affect your daily life, but it won’t hold the same weight as a nexus letter written by a medical provider. A nexus letter is a different type of document and must come from a medical provider. The nexus letter contains a medical opinion with an explanation of the link between your military service and your claimed condition. While your personal statement is important, it is not the same as a nexus letter.
Can a VA Doctor Write a Nexus Letter?
VA-employed doctors often face limitations when it comes to writing nexus letters for veterans. Since they work under the Department of Veterans Affairs (VA), there can be concerns about conflicts of interest. Their primary responsibility is providing medical care within the VA system, not assisting with disability claims. It’s common for VA doctors to be discouraged, or even directed, by their leadership to avoid writing nexus letters or completing Disability Benefits Questionnaires (DBQs), even though veterans’ service officers might recommend these documents. If a VA doctor does choose to write a nexus letter, it is generally something they do in their personal time, outside of their VA duties. While some VA doctors may be willing to help, many prefer not to. Because of these potential conflicts, veterans often turn to non-VA healthcare providers or specialized consultants to get the needed nexus letters, ensuring clarity and professional backing for their disability claims.
How to Get a Nexus Letter for Your VA Claim
After you’ve learned who can write a nexus letter, the next step is choosing the right medical provider to help with your case. No matter who you choose, you’ll need to gather and organize all your important documents. This means your service treatment records, medical records, dates of service, and even previous rating decisions. These papers give your provider a clear picture of your claim.
If you decide to work with Valor 4 Vet, here’s how to get started:
- Register for a Portal Account: Sign up on our website to create your Portal account.
- Upload Your Documents: Once registered, upload your records into the evidence folder. This step is important so your chosen specialist can review your full history.
- Order Review: After all your evidence is uploaded, click on “Order Review” and select the specialist you want to review your records.
- Order Your Nexus Letter: Our medical experts will review your documents and let you know if you’re approved for a nexus letter. If approved, you’ll receive a link in your Portal Order Details to order your nexus letter.
By following these steps, you’ll be well on your way to obtaining a strong nexus letter that supports your VA claim.
How Long Should a Nexus Letter Be?
Some companies charge high fees for nexus letters that don’t help your case and are filled with unnecessary details. The VA doesn’t want a 20+ page nexus letter. Instead, the letter should be directly relevant to your condition and focused on the key points. It should be clear, concise, and effective. In fact, even the VA’s own medical providers don’t write long medical opinions. The longest nexus letter Valor 4 Vet has written for the VA was 13 pages, and that was only due to the complexity of the case. Additionally, avoid attaching long resumes—anything more than 5 pages is unnecessary.
At Valor 4 Vet, we focus on delivering clear, effective nexus letters without the fluff or high prices.
Why Doesn’t Valor 4 Vet Submit the Nexus Letter to the VA?
It’s important to remember that the medical providers who write nexus letters are not your legal representatives. Their role is to serve as an independent witness to your claim by providing an expert medical opinion. They aren’t here to decide when or how you should submit the letter to the VA—that decision is up to you or your legal representative.
Timing matters when it comes to submitting evidence, and it can affect how your disability claim is decided. At Valor 4 Vet, we will verify your nexus letter and ensure its content exceeds the Department of Veterans Affairs’ requirements, giving you the best possible support for your claim from the independent witness perspective.
What Document in the VA Does a Nexus Letter Fall Under?
When submitting a nexus letter in your VA claim, make sure to mark it as “OTHER” in question 16 of VA form 20-10208. In the description section, simply write “Private medical opinion” to clarify that the letter comes from an independent healthcare provider.
You can find VA form 20-10208 here.
How to Submit a Nexus Letter to the VA
After you have your nexus letter, take a moment to verify its accuracy and ensure it includes referenced medical literature. Once you’re confident in its quality, it’s time to submit it to the VA.
Here are your submission options:
- Upload via eBenefits: When filing a new or supplemental claim, attach your nexus letter directly through the VA’s eBenefits portal.
- Fax Submission: Fax your nexus letter to the Evidence Intake Center using these toll-free numbers: 844-531-7818 or 248-524-4260.
- Mail Submission: Mail your nexus letter with the appropriate coversheet. Be sure to get a tracking number. Use VA Form 20-10208 as your coversheet.
Department of Veterans Affairs
Evidence Intake Center
P.O. Box 4444
Janesville, WI 53547-4444
You can find VA Form 20-10208 here.
Before you submit your letter, be sure to keep a copy for your personal records. This ensures you have a backup and can reference it later if needed.
Can a Veteran’s Claim Be Helped by Their Own Statement?
While a veteran’s own statement cannot replace a nexus letter, it can provide important context regarding how a condition affects daily life or describe in-service events that contributed to the condition. For example, you might write a personal statement detailing specific incidents, such as exposure to Agent Orange or a traumatic event in combat.
Pairing a personal statement with a strong nexus letter can strengthen your overall claim by providing both medical and personal perspectives.
What is a DBQ?
A Disability Benefits Questionnaire (DBQ) is a VA form completed by a medical provider that provides specific details about a veteran’s claimed medical condition. Unlike a nexus letter, which establishes the connection between the condition and military service, a DBQ is focused on documenting the severity and symptoms of the veteran’s condition. The information provided in the DBQ determines the disability rating percentage assigned by the VA Rater.
DBQs are useful for claims because they ask standard questions related to the VA Rating Schedule, giving the VA specific information to review.
Will a Nexus Letter Provider Also Provide a DBQ?
This depends on the provider. Some medical providers who specialize in writing nexus letters may also complete a DBQ for your condition, while others might exclusively draft nexus letters. It’s important to ask upfront whether the provider offers both services, as a completed DBQ can be a valuable addition to your claim.
At Valor 4 Vet, we offer DBQs for Mental Health Conditions and a limited number of online DBQs that currently include chronic fatigue syndrome, erectile dysfunction, GERD, irritable bowel syndrome, migraine headaches, and sleep apnea. You can access our online DBQs inside the Valor 4 Vet Portal.
Start your nexus letter or DBQ by registering with Valor 4 Vet. Since 2015, we have been proudly supporting veterans as medical expert witnesses for VA claims.
