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Veterans Law

How Do I Get a Nexus Letter for Sleep Apnea?

Michael Lostritto

April 10, 2024

How Do I Get a Nexus Letter for Sleep Apnea?

Sleep apnea is a common diagnosis among veterans, but it is still a challenging claim to make for VA disability benefits. VA rejects approximately a third of disability claims in general.

On top of this, many cases of sleep apnea and other sleep disorders are a secondary disability—for example, caused by post-traumatic stress disorder (PTSD), rather than a direct result of an in-service event—making them even more complicated to prove.

A nexus letter may help significantly.

Independent Medical Opinion: VA Nexus Letter

The Process for Obtaining a Nexus Letter

To obtain a nexus letter for sleep apnea, follow these steps:

  1. Find a Licensed Provider: The VA only accepts nexus letters written by licensed providers. Unlike C&P exams, VA will not identify a medical professional or set up an appointment for a nexus letter. It is the veteran’s responsibility to find a VA or VA-contracted physician or private physician who is qualified to evaluate their condition.
  2. Gather Evidence: The physician will have the veteran undergo a sleep study. The physician will also need to see the veteran’s medical and service history. The veteran should collect and attach relevant documents such as any earlier VA decisions, prior sleep studies, and evidence about how their condition is service-related.
  3. Ensure a Quality Nexus Letter: The physician’s letter should state that, in the provider’s professional opinion, the veteran’s sleep apnea is caused by an in-service event, injury, or illness. A good nexus letter usually includes the doctor’s credentials, a nexus opinion, an evidence-based rationale, and an explanation of the impact on the veteran’s life. A physician experienced in writing nexus letters will be able to include the keywords that VA considers most persuasive. For example, it is vital a physician state that your condition is “at least as likely as not” related to military service to satisfy VA’s standard of proof.

While a nexus letter is not mandatory for VA claims related to sleep apnea, having one can significantly strengthen a VA benefits claim by providing medical evidence linking the sleep apnea to military service.

Asking for Help with Nexus Letters

When preparing an initial claim for disability benefits, veterans will typically start with a VA-accredited Veterans Service Organization (VSO) like Disabled American Veterans (DAV).

If VA denies your claim for sleep apnea disability benefits, it is time to reach out to an experienced, VA-accredited law firm like Chisholm Chisholm & Kilpatrick.

CCK is the largest veterans law firm in the US and has helped veterans recover over $1 billion in benefits since 1999. Contact CCK for a free case evaluation at (800) 544-9144. Do not delay, as there are deadlines to consider when pursuing appeals.

About the Author

Bio photo of Michael Lostritto

Michael joined CCK in September of 2016 as an Attorney, was named Supervising Attorney in 2021, and now serves as a Managing Attorney. His practice focuses on the representation of disabled veterans before the Department of Veterans Affairs and the United States Court of Appeals for Veterans Claims.

See more about Michael