How to Get a VA Nexus Letter

One of the most important pieces of evidence in many VA disability claims is the nexus letter.

A nexus letter is a medical opinion that explains the connection between a veteran’s current medical condition and military service.

Without a clear nexus, the VA may conclude that the condition is not service connected, even when the veteran strongly believes the connection exists.

What a Nexus Letter Does

A nexus letter explains how a current condition is related to military service.

It typically includes:

• a description of the veteran’s medical condition

• a review of relevant medical history

• an explanation of how the condition may be connected to service

• the physician’s professional opinion on the likelihood of that connection

In VA claims, the key phrase is often “at least as likely as not.”

This standard means the doctor believes there is at least a 50 percent probability that the condition is related to service.

Who Can Write a Nexus Letter

A nexus letter must come from a qualified medical professional.

This may include:

• a treating physician

• a medical specialist

• a licensed psychologist or psychiatrist

• another qualified healthcare provider familiar with the condition

The medical professional should review the veteran’s relevant medical records before forming an opinion.

When a Nexus Letter Is Most Helpful

A nexus letter is often useful when:

• the connection between service and the condition is not obvious

• the VA previously denied a claim due to lack of medical evidence

• the condition developed years after service

• a secondary condition is being claimed

In many cases, a well-supported medical opinion can clarify the connection between service and the condition.

Supporting Evidence

A nexus letter is most effective when supported by other documentation.

Helpful supporting evidence may include:

• service treatment records

• medical records documenting symptoms

• diagnostic testing

• medical literature supporting the relationship between conditions

Together, this evidence helps provide a clearer picture of how the condition developed.

Learn More About VA Disability Claims

If you want to understand how VA disability claims are evaluated, you may find these articles helpful:

• The Three Elements Every VA Disability Claim Must Prove

• What Evidence Does the VA Need to Approve a Disability Claim

• What to Do After a VA Disability Claim Denial

These guides explain how the VA evaluates evidence and what veterans can do to strengthen their claims.

Donald “Chris” Burnette is an attorney and Air Force veteran who focuses on federal law and matters before federal agencies, including the Department of Veterans Affairs. Before starting the Law Office of D.C. Burnette, PLLC, he served in federal leadership roles within the Department of the Interior and National Park Service. His practice helps veterans, federal employees, and mission-driven organizations navigate complex federal systems.