Step 1: Has VA Ever Rendered a Decision to You on This Condition Before?

If you have never filed this condition before

You will generally be filing a new disability claim.

The VA explains that an original claim for direct service connection generally needs evidence supporting three things:

1. You have a current disability.
2. An event, injury, or disease occurred during qualifying military service.
3. There is a link between your current disability and the in-service event, injury, or disease.

That third element is called the Nexus.

The VA specifically recognizes medical records and medical opinions from healthcare providers as evidence that may support this connection. Your Nexus Letter provides the key medical evidence addressing this part of your claim.

If the VA has already denied this condition

The VA has a separate decision-review system for conditions it has already decided.

If you now have new evidence, such as a Nexus Letter the VA has never previously considered, a Supplemental Claim may be a better option. The VA defines:

• New evidence as information the VA did not previously consider.
• Relevant evidence as information that tends to prove or disprove something at issue in the claim.

A Nexus Letter that the VA has never reviewed and that addresses the reason for a previous denial may therefore be relevant to a Supplemental Claim.

What is a Higher-Level Review?

A Higher-Level Review is different from a Supplemental Claim, but is another way to appeal a denial.

A Higher-Level Reviewer looks at the evidence that was already in the VA's record when the prior decision was made. You cannot submit new evidence with a Higher-Level Review.

Board Appeals

A Veteran may also have the option to appeal a decision to the Board of Veterans' Appeals.

Board Appeals have their own procedures and evidence rules, so consider speaking with a VA-accredited representative if you are unsure which decision-review path is appropriate.