You’ve got a diagnosis. You served in the military. You’re certain your condition was caused—or made worse—by your service. But here’s the catch: the VA won’t automatically connect those dots for you. That’s where a nexus letter comes in. It can be the single most critical document in your entire VA disability claim.
What Is a Nexus Letter?
A nexus letter is a written medical opinion from a qualified healthcare professional linking your current disability to your military service. “Nexus” simply means connection. The VA relies on this document to determine whether your disability is service-connected—the foundation of every benefits decision.
Without a nexus letter or strong medical evidence proving that connection, the VA can still deny your claim—even if your diagnosis is undisputed. They’re not denying you’re sick; they’re denying that the military caused your condition.
Why Nexus Letters Matter
The VA reviews thousands of claims each month, and many are denied simply because they lack clear medical reasoning. This is especially true for invisible or complex conditions like PTSD, anxiety, or chronic pain. A detailed, evidence-based nexus letter bridges that gap and provides the “why” behind your claim.
A well-written nexus letter can mean the difference between a denied claim and full approval. It can help increase your rating, support TDIU eligibility, or turn a past denial into a successful appeal.
What the VA Looks For in a Nexus Letter
VA decision-makers focus on three essential elements:
- Medical Reasoning — The provider must clearly explain why your condition is connected to service. They should reference your medical records, service events, and symptoms. Vague or speculative wording won’t hold up.
- Service-Specific Details — The letter should directly mention your experiences. For PTSD, that could mean referencing combat exposure, training accidents, or military sexual trauma—specific details that link your diagnosis to your service.
- Provider Credentials — The letter carries more weight when written by a qualified medical specialist. A psychiatrist’s opinion on PTSD, for example, is much stronger than one from a general practitioner or chiropractor.
Common Nexus Letter Mistakes
Many nexus letters fail because they’re too generic or lack the right medical support. Common problems include:
- Weak wording like “it is possible” or “may be related”
- No mention of specific service events or stressors
- Missing references to medical records or diagnostic standards
- Letters written by providers outside their field of expertise
- Hastily written letters without reviewing full documentation
How to Get a Strong Nexus Letter
When you request a nexus letter, don’t just ask your doctor to “write one.” Give them what they need to help you: your service dates, diagnosis, relevant stressors, and copies of your medical or service records. Explain that you’re filing for VA disability benefits and need their professional opinion on whether your condition is connected to your service.
Give them time to prepare it carefully. Offering a sample or guidance sheet can also help them include the information the VA looks for—without “coaching” the answer.
When a Nexus Letter Is Essential
While some claims are clear-cut, most aren’t. For mental health disorders, chronic pain, or secondary conditions that stem from an existing service-connected disability, a nexus letter can make all the difference. Even if your initial claim was denied, a strong nexus letter can be the key to winning your appeal.
Get Expert Help
Nexus letters can make or break your case—and getting one that meets VA standards takes strategy and experience. At McKown and Myers, we help Indiana veterans secure the medical opinions and evidence they need to prove service connection and win their claims.
If you’re unsure whether you need a nexus letter or want help building your case, call 765-668-7531 or fill out our contact form for a free consultation. Your service earned these benefits—let us help you claim them.