A VA nexus letter, also known as an Independent Medical Opinion (IMO), is a crucial document in supporting a veteran’s disability claim. It establishes a direct link (nexus) between a veteran’s current medical condition and their military service. This letter, written by a qualified medical professional, provides expert medical opinion confirming that the condition is “at least as likely as not” caused by events or injuries sustained during service. A strong nexus letter significantly increases the chances of a successful VA disability claim.
The key component of a nexus letter is a well-reasoned medical opinion, supported by evidence from the veteran’s medical records, service records, and relevant medical literature. The doctor should demonstrate a thorough understanding of the veteran’s medical history and how their service-related incidents could have led to their current disability. Vague or unsubstantiated claims will not be as effective. Specificity and evidence are paramount.
While a nexus letter isn’t a guaranteed win, its importance cannot be overstated. It addresses a fundamental requirement of the VA’s disability claim process: establishing a connection between military service and the claimed disability. Without a credible nexus, the VA may deny the claim, even if the veteran demonstrably suffers from a debilitating condition. This page offers eleven sample letters to guide you; however, each situation is unique and requires tailoring the letter to the specific circumstances.
11 Sample VA Nexus Letters
Sample Letter 1: PTSD Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am writing to provide my medical opinion regarding [Veteran’s Name] and their diagnosis of Post-Traumatic Stress Disorder (PTSD). I have reviewed [Veteran’s Name]’s medical records, service records, and conducted a thorough examination on [Date of Examination].
Based on my professional opinion, it is at least as likely as not that [Veteran’s Name]’s PTSD is directly related to their experiences during their military service in [Branch of Service] from [Start Date] to [End Date], specifically their exposure to [Specific Traumatic Event]. The symptoms reported and observed are consistent with the psychological trauma associated with such events.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 2: Tinnitus Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
This letter is to provide my professional opinion regarding the Tinnitus diagnosis of Veteran [Veteran’s Name], and its possible relation to his/her military service. After reviewing [Veteran’s Name]’s records and conducting a thorough ear examination, including audiometric testing, I have made the following determination.
It is at least as likely as not that the Veteran’s Tinnitus condition is a result of loud noise exposure while serving in the [Branch of Service] from [Start Date] to [End Date]. He/She was frequently exposed to small arms fire and machinery without proper ear protection and reports symptoms that correlate to this.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 3: Back Pain Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am writing to provide my professional medical opinion regarding [Veteran’s Name]’s chronic back pain. I have reviewed their medical records, service records, and conducted a physical examination on [Date of Examination].
Based on my review and examination, it is at least as likely as not that [Veteran’s Name]’s chronic back pain is a direct result of the physical demands of their military service in the [Branch of Service] from [Start Date] to [End Date], specifically related to [Specific Activities such as heavy lifting, parachute jumps, etc.]. The MRI findings of [Specific MRI findings, e.g., degenerative disc disease] are consistent with the chronic strain and stress placed on their spine during their time in service.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 4: Knee Injury Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
This letter concerns the knee injury and subsequent chronic pain experienced by [Veteran’s Name]. I have thoroughly reviewed his/her medical records from their time both in service and after, and believe it is at least as likely as not that their service is directly related to their injury.
[Veteran’s Name] sustained a knee injury during [Specific activity] in [Year]. While the initial treatment may have been effective enough for him/her to continue their service, it has led to further complications and chronic pain. This pain can be directly linked to the original injury, due to both physical therapy notes and MRI results.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 5: Agent Orange Exposure (Diabetes) Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am writing to provide my medical opinion regarding [Veteran’s Name] and their diagnosis of Type 2 Diabetes Mellitus. I have reviewed [Veteran’s Name]’s medical records, service records, and conducted a thorough examination.
Based on my professional opinion, it is at least as likely as not that [Veteran’s Name]’s Type 2 Diabetes is related to their exposure to Agent Orange during their service in [Vietnam/Specific Location] from [Start Date] to [End Date]. The Institute of Medicine (IOM) has established a positive association between Agent Orange exposure and the development of Type 2 Diabetes. [Veteran’s Name]’s service records indicate their presence in an area where Agent Orange was utilized.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 6: Sleep Apnea Nexus Letter (Secondary to PTSD)
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
This letter is to provide my professional opinion regarding the Sleep Apnea diagnosis of Veteran [Veteran’s Name]. After reviewing [Veteran’s Name]’s records and conducting a thorough sleep evaluation, I have made the following determination.
It is at least as likely as not that the Veteran’s Sleep Apnea is a secondary condition caused by his pre-existing service-connected PTSD. His symptoms have been determined to be caused by the PTSD, specifically his anxiety during the night. This anxiety has caused the Sleep Apnea to develop and has aggravated it.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 7: Migraine Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am writing to provide my medical opinion regarding [Veteran’s Name]’s chronic migraines. I have reviewed their medical records, service records, and conducted a neurological examination.
Based on my review and examination, it is at least as likely as not that [Veteran’s Name]’s chronic migraines are related to the stressors and potential traumatic brain injuries (TBI) sustained during their military service in the [Branch of Service] from [Start Date] to [End Date]. The exposure to [Specific stressors, e.g., combat, explosions, sleep deprivation] likely contributed to the development of their migraines.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 8: Arthritis Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
This letter is written to provide my expert medical opinion on the case of [Veteran’s Name] and their diagnosis of arthritis. After a thorough review of their medical and service records, along with a physical examination, I have come to the following conclusion.
It is at least as likely as not that [Veteran’s Name]’s current arthritic condition is a direct result of the strenuous activities and physical demands placed upon them during their service in the [Branch of Service] between [Start Date] and [End Date]. These activities have caused significant and lasting damage to their joints, leading to premature development of the arthritis.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 9: Hip Pain Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am providing my professional medical opinion regarding Veteran [Veteran’s Name]’s chronic hip pain. I have thoroughly reviewed his medical and service records and conducted an exam of their hip.
Based on my findings, it is at least as likely as not that his current hip pain and limited mobility are a result of injuries sustained while he served in the [Branch of Service] during the years of [Start Date] to [End Date]. Specifically, these injuries were caused by repeated strenuous activity such as [Examples: hiking with heavy loads, frequent jumping/landing] leading to the early onset of degeneration and arthritic changes in the hip joint.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 10: Gulf War Syndrome (IBS) Nexus Letter
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am writing to provide my medical opinion regarding [Veteran’s Name] and their diagnosis of Irritable Bowel Syndrome (IBS). I have reviewed [Veteran’s Name]’s medical records, service records, and conducted a thorough examination.
Based on my professional opinion, it is at least as likely as not that [Veteran’s Name]’s IBS is related to their service during the Gulf War from [Start Date] to [End Date]. IBS is a common symptom associated with Gulf War Syndrome, which is a presumptive condition for veterans who served in the Gulf War theater.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Sample Letter 11: Peripheral Neuropathy Nexus Letter (Secondary to Diabetes)
[Date]
Department of Veterans Affairs
[Address]
RE: Veteran: [Veteran’s Name], Claim Number: [Claim Number]
To Whom It May Concern:
I am writing to provide my medical opinion regarding [Veteran’s Name] and his peripheral neuropathy. Having reviewed his medical history, his service records, and conducted a physical examination, I have come to a conclusion.
It is at least as likely as not that the Veteran’s peripheral neuropathy is a secondary condition related to their Type 2 Diabetes. Based on literature in my medical specialty, I have determined that the neuropathy has likely developed and been triggered by [Veteran’s Name]’s diabetic condition.
Sincerely,
[Doctor’s Name], MD
[Doctor’s Credentials]
Conclusion
These sample nexus letters serve as templates and should be adapted to reflect the veteran’s specific circumstances and the medical professional’s expert opinion. Remember to provide comprehensive medical documentation, a clear connection between the disability and service, and a strong “at least as likely as not” statement. Consult with a qualified veterans law attorney or advocate for personalized guidance and assistance with your VA disability claim.
