What is a VA Nexus Letter?
A VA Nexus Letter is an Independent Medical Opinion (IMO) that explains the connection between a Veteran's diagnosed condition and their military service (direct to service), or between a new condition and an existing service-connected disability (secondary). A strong Nexus Letter is based on your medical records, relevant medical research, and a clear explanation from the Doctor about why that connection exists for you.
Do I need a Nexus Letter for my VA disability claim?
While not every VA disability claim needs a Nexus Letter they are part of a fully developed claim. Nexus Letters are most useful when the missing or disputed part of your claim is the medical connection between your condition and your military service (Not Service Connected), or between a new condition and a condition that is already service connected (secondary claims).
What makes a strong VA Nexus Letter?
A strong Nexus Letter explains your personal medical history, identifies the important diagnoses and records, explains the medical relationship involved, uses relevant medical research when appropriate, and gives the VA a clear medical rationale for the Doctor's opinion. A strong Nexus Letter spoon feeds your claim to the VA in a way that is difficult for them to ignore.
What does "at least as likely as not" mean in a VA Nexus Letter?
"At least as likely as not" is common VA language used to describe a medical relationship that is supported at roughly a 50 percent probability or greater. When appropriate, our Doctors use VA-specific language while also explaining the medical evidence behind their opinion.
What does "but for" mean in a VA Nexus Letter?
"But for" is common VA language used to describe a medical relationship that is caused by one condition or circumstance leading to another. An example would be: my back hurts "but for" my altered gait compensating for how I walk on my bad knee. When appropriate, our Doctors use VA-specific language while also explaining the medical evidence behind their opinion.
What is an Independent Medical Opinion for a VA disability claim?
An Independent Medical Opinion, often called an IMO or Nexus Letter, is a medical opinion from a qualified provider who independently reviews your records and explains whether your diagnosed condition is connected to military service or another service-connected condition.
Can a Nexus Letter help with a denied VA disability claim?
Yes. If your claim was denied because the VA did not find enough medical evidence connecting your condition to service, a Nexus Letter may help address that problem. The reason for the denial matters, so reviewing the actual records and decision is important.
Can I use a Nexus Letter with a VA Supplemental Claim?
Yes. A Supplemental Claim allows you to submit new and relevant evidence, and a Nexus Letter can be used as new medical evidence when it addresses a missing or disputed connection. Sometime a Nexus Letter on its own is enough new evidence for a supplemental claim to be overturned.
Can I submit a new Nexus Letter during a Higher-Level Review?
No. A Higher-Level Review generally does not allow you to submit new evidence. If you have a new Nexus Letter or other new medical evidence, a Supplemental Claim or another review option may make more sense.
Can a Nexus Letter support a secondary VA disability claim?
Yes. A secondary claim involves a condition that is caused by or aggravated by a disability that is already service connected. A medical opinion can help explain and support that relationship.
Can Nexus Veterans help identify secondary conditions?
Yes. During our Records Analysis, we review your medical records for diagnosed conditions and possible medical relationships. Your Eligible Condition Summary shows which conditions we can currently support and which ones may need more records or another eligible condition first.
How does Nexus Veterans determine whether I am eligible for a Nexus Letter?
We start with your medical records and service records. Our team reviews them and creates an Eligible Condition Summary that shows which conditions are medically supported, which ones need more information, and which ones we cannot currently support.
What is an Eligible Condition Summary?
The Eligible Condition Summary is the report you receive after your Records Analysis. It breaks your conditions into three groups: Eligible Conditions, Needs More, and Not Eligible, with an explanation of what we found and why.
What happens if Nexus Veterans do not find an eligible condition?
If we do not find any eligible conditions during your Records Analysis, your new-client onboarding fee is refunded.
How much does the Nexus Veterans Records Analysis cost?
New-client onboarding and Records Analysis costs $95. That includes help collecting your records, review of your medical records, and your Eligible Condition Summary.
Do I have to pay the $95 Records Analysis fee again later?
No. The $95 onboarding fee is a one-time fee. You can bring us additional records or future diagnoses later without paying the onboarding fee again.
How much does a VA Nexus Letter cost through Nexus Veterans?
Nexus Letters range from $600 to $750 per letter depending on volume. A single letter is $750. Orders of five or more letters are $600 per letter.
Do Nexus Veterans offer payment plans for Nexus Letters?
Yes. We offer payment plan options through Affirm, Klarna, and Afterpay, subject to each provider's approval and terms.
How long does it take to get a Nexus Letter?
Records Analysis usually takes up to one week after we receive the records we need. Once you select your letters and they are routed to a Doctor, letter writing can take up to two weeks. The entire process can often be completed in under three weeks once we have your records.
How do I send my medical records to Nexus Veterans?
Our Records Manager will walk you through it. You can upload records through a secure link, email them to us, or send physical records that we can digitize for you.
What medical records should I provide for a VA Nexus Letter?
Send us the records you have that relate to the conditions you want reviewed. Depending on the condition, that might include treatment records, diagnoses, imaging, audiology reports, sleep studies, specialist records, C&P exam records, or VA decision letters. If something important is missing, we will let you know during the Records Analysis.
Can Nexus Veterans review both VA and private medical records?
Yes. We can review relevant records from both VA healthcare providers and private providers to understand your diagnoses, treatment history, and possible medical relationships.
What happens if my records show a condition but I am missing an important test or report?
We may list that condition as Needs More instead of ruling it out. For example, your records may mention an audiology test, imaging study, sleep study, or specialist report that was not included. We will tell you what is missing and what could help strengthen the medical analysis.
What types of medical conditions can Nexus Veterans write Nexus Letters for?
Our Doctor network covers a wide range of physical and mental health conditions. We match each eligible condition to a provider with the right background and experience for that specific medical issue.
How do Nexus Veterans choose the Doctor for my Nexus Letter?
We match each condition to a Doctor based on relevant experience, specialty, and licensing. Mental health, musculoskeletal, sleep, cardiac, internal medicine, and other conditions are routed to providers whose background fits the condition being reviewed.
Does a real Doctor write my Nexus Letter?
Yes. Eligible conditions are routed to licensed medical professionals in our Doctor network. The Doctor reviews the evidence and is responsible for the medical opinion and reasoning in the final letter.
Are Nexus Veterans Doctors familiar with VA disability claims and 38 CFR?
Yes. Our Doctors are trained to prepare medical opinions for VA disability claims and understand the language, standards, and evidence used in the VA process. When appropriate, letters may include medical research, VA terminology, and relevant regulatory standards.
Does Nexus Veterans use medical studies in its Nexus Letters?
Yes. Our Doctors can use peer-reviewed medical research to support the medical reasoning in a letter. The research supports the individual case. It does not replace the actual review of your records.
Can Nexus Veterans guarantee that the VA will approve my disability claim?
No. Nobody can guarantee how the VA will decide a claim. Our job is to provide a thorough medical review and a well-supported medical opinion for conditions that our Doctors can substantiate.
Does Nexus Veterans file my VA disability claim for me?
No. Nexus Veterans provides Records Analysis and medical opinion services. You can submit your claim and evidence yourself, or work with a VA-accredited VSO, claims agent, or attorney if you want help filing or representing your claim.
Is Nexus Veterans a law firm or Veterans Service Organization?
No. Nexus Veterans provides administrative support, Records Analysis, and medical opinion services for Veterans. We do not provide legal representation. We are happy to work with your VA-accredited attorney, claims agent, or VSO if you have one.
Can Nexus Veterans help if I don't know what conditions I should claim?
Yes. That is one of the main reasons we start with a Records Analysis. Instead of asking you to guess which conditions may be supportable, we review your records and show you what the medical evidence currently supports.
Can Nexus Veterans help with an initial VA disability claim?
Yes. A Nexus Letter can be useful for an initial claim when medical evidence is needed to explain the connection between a diagnosed condition and your military service.
Can Nexus Veterans help Veterans who are already service connected?
Yes. Veterans who are already service connected may have other diagnosed conditions that could be medically related to an existing service-connected disability. Our Records Analysis helps identify conditions that may be appropriate for further medical review.
Can Nexus Veterans help if the VA says there is “no nexus” or “no link” to service?
Yes, potentially. If the VA says there is no nexus or no medical link, that usually means the medical connection is one of the issues in the claim. We can review your records to see whether one of our Doctors can medically support that connection with an independent opinion.
Does Nexus Veterans work with Veterans nationwide?
Yes. Nexus Veterans is U.S.-based and works with Veterans across the country.
Is my medical information kept private?
Yes. We provide secure ways to send us your records and use safeguards to protect your personal and medical information.
Nexus Veterans