A “nexus” is a link between a veteran’s current, diagnosed disability and an in-service event, injury, or illness. VA requires a veteran to provide a nexus for their claim for service connection in a majority of cases. A veteran can fulfill this requirement by having a medical professional write a nexus opinion for their claim. If a link is not provided in the early development stages of a claim for service connection, VA may schedule a veteran for a Compensation and Pension examination (C&P) in order for a VA examiner to determine if there is a link between a veteran’s disability and their military service.
When Your Doctor Writes a Nexus Letter
Veterans can ask their physicians to write a VA nexus letter for their claim to satisfy the VA requirement. However, not all nexus letters will be given the same weight by VA. A strong nexus letter should:
- Be written by a licensed professional in the appropriate medical or clinical field
- Be based on the veteran’s service medical and personnel records.
- Be based on the veteran’s medical history before, and following, service.
- Address whether it is “at least as likely as not” that the veteran’s disability was incurred in or caused by service.
The “at least as likely as not” language addresses VA’s standard for proving service connection. VA does not require a veteran to show beyond a reasonable doubt that their disability was caused by service. Rather, the veteran must show that it is at least as likely as not caused by service, meaning that there is at least a 50 percent chance that the disability was incurred in or caused by military service.
Why the Doctor Should Look at Your Medical Records
The doctor who writes your letter should review your entire VA claims file. If a doctor does not review all of the evidence relevant to your claim, VA may dismiss the doctor’s nexus opinion. A strong nexus letter will be based on the veteran’s file and address any inconsistencies in the veteran’s record regarding their condition.
The doctor should also be able to point to specific records in the claims file to support their opinion that the veteran’s condition is at least as likely as not due to their time in service. Citing to specific instances or medical records can strengthen the link.
Why Is a Nexus Important?
A nexus is important because fulfills the third requirement of service connection. In order for VA to grant service connection, the veteran must demonstrate three things:
- A current diagnosed disability
- An in-service event, injury, or illness
- A medical nexus linking the veteran’s diagnosed disability with the in-service occurrence.
Without a medical nexus, VA can deny a veteran’s claim for service connection. VA must be able to identify a link between a veteran’s knee condition, for example, and an occurrence in service. Otherwise, the injury is not by definition service connected.
Note: Presumptive service connection does not require a medical link between service and a current diagnosis. In this instance, VA presumes that the veteran’s military service caused their disability.