THE NEXUS LETTER - Service-Connected Disability Claim

Sep 15, 2026

Guidance on preparing a Nexus letter for a veteran’s service-connected disability claim with the Department of Veterans Affairs. Explains that a favorable decision typically requires evidence of an in-service event, a current diagnosis of the same condition, and a medical opinion linking the two. Details how to express likelihood using VA-recognized degrees, emphasizes rationale and review of pertinent records, and warns that many denied claims result from an absent or poorly written letter, followed by an example template.

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CategoryLetters

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Pages2

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THE NEXUS LETTER

Required elements for a favorable claim

Degrees of likelihood in the medical opinion

What a proper Nexus letter must include

EXAMPLE OF A NEXUS LETTER

Letter header and addressee

Doctor statement and required content

Opinion, rationale, and signature

# THE NEXUS LETTER There are certain important things in this world that we only get one shot at.Such is the Nexus letter in aveteran's service-connected disability claim with the Department of Veterans Affairs.Although only oneNexus letter is required,it is advisable to seek the overwhelming number of three individual and concurringNexus letters if possible.The Nexus letter may require a lot of effort on the part of the veteran,but the return isindispensable. Generally,according to the law,three elements are necessary and therefore required to obtain a favorabledecision by a veteran for service-connected benefits. \#1-An event in service that could have caused or aggravated a disease or condition \#2-A present day diagnosis of the existence of the same disease or condition \#3-A medical opinion linking number 1 with number 2 The required medical opinion is called a Nexus letter.The letter must be written specifically for the individualand explicit to that individual's claim.It is important that the opinion be expressed as a degree of likelihood.The degrees of likelihood,arranged in ascending order from the lesser to the greater are as follows,"notlikely","at least as likely as not","more than likely","and highly likely". In the case of "at least as likely as not",the veteran always receives the benefit of doubt and therefore theoutcome is considered a favorable opinion.The doctor,or expert,does not have to use absolutes or conclusionsin the statement.Opinions are gleaned by a review of the pertinent records and facts.A professional opinioncan then be rendered based upon the record,the medical history,the facts,and the education and/or experienceof the author of the letter. Most denied veterans’claims failed because of the lack of a Nexus letter altogether or the lack of a properlywritten Nexus letter. A proper Nexus letter must be as brief as possible while stating the facts and must include the following: "After a review of the veterans pertinent records"-(use medical and any service records furnished by theveteran to show the event in service) "It is my professional opinion that it is at least as likely as not'-(choose and insert the proper degree oflikelihood,see above choices) The author must offer a rationale as to the opinion in the statement-(e.g."It is well known in medicaljournals") Trthopedio suseorenidirorentialinicfaci ely A tiles or specialties-(e-g,Onclogist,Hematologist, Please understand that the VA often uses credentials to assign probative value to the nexus letter. # EXAMPLE OFA NEXUS LETTER Note:This is not a form to fill out.Please re-type the followinginformation onto your professional letterhead/stationery.Thank you for your time and consideration. DATE Reference:(Veteran's nme) SS\# VA File\# # To Whom It May Concern, I am Dr .I am board certified to practice in my specialty.My credentials are included.I have beenasked to write a statement in support of the aforementioned veteran's claim. I have personally reviewed his medical history-(name the doczments).I have also reviewed and have notedthe circumstances and events of his military service,which include (ncme the event or events you clain are thecanse ofthe condition),in the years (list dates of service)while in military service Mr. _is a patient under my care since(enter Dnte).His diagnosis is (name thecondition). I am familiar with his history and have examined Mr. often while he has been under my care.(specify lab work,x-rays,ete.) Mr. has no other known risk factors that may have precipitated his current condition After a review of the pertinent records it is my professional opinion that it is (choose a likelihood from below)that Mr. 's condition is a direct result of his fevent in service)as due to his military service.(Choose one de

FAQs

What are the three elements needed for a favorable VA service-connected benefits decision?

The claim generally requires an in-service event that could have caused or aggravated a disease, a current diagnosis of the same condition, and a medical opinion linking the in-service event to the present diagnosis.

How should the medical opinion’s likelihood be expressed in a Nexus letter?

The opinion must state a degree of likelihood using the VA-recognized options such as "not likely," "at least as likely as not," "more than likely," or "highly likely." For "at least as likely as not," the outcome is considered favorable due to the benefit of doubt.

What content must a proper Nexus letter include to support the claim?

A proper letter should be as brief as possible while stating the facts, including a statement that pertinent records were reviewed, a professional opinion with the chosen likelihood degree, and a rationale supporting the linkage based on records, medical history, facts, and the author’s expertise.

Sep 15, 2026

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