How to Get a VA Nexus Letter
Updated: Oct 5
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:
• What Evidence Does the VA Need to Approve a Disability Claim
These guides explain how the VA evaluates evidence and what veterans can do to strengthen their claims.
D.C. Burnette is a U.S. Air Force veteran, Missouri-licensed attorney, VA-accredited attorney, and member of the bar of the U.S. Court of Appeals for Veterans Claims. The Law Office of D.C. Burnette, PLLC focuses on VA disability claims and appeals, CAVC cases, and selected military matters.
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