The A - Z Guide: Veterans VA Disability Benefits
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How To Write
An Effective Nexus Letter

The nexus letter, when properly written, is the most effective tool you have at your disposal.

You must pay attention to detail. Missing just one little point will undo the rest of the letter.

Nexus Letter

The Veterans Administration disability compensation claim requires 3 fundamental elements.

(1) Proof of eligibility through qualifying service.

(2) Evidence of an event during active duty military service that a reasonable person would believe may have caused or contributed to a disabling injury or illness (called a "condition" by VA).

(3) Evidence that there exists today a condition that is so disabling that it may be rated according to the Schedule For Rating Disabilities.

There must also be shown that there is a connection (nexus) between (2) and (3).

For example; You may have injured your knee in service during a training exercise. You went to sick call, an examination was done and simple x-rays were taken. You were prescribed ibuprofen, an ACE bandage and a light duty profile for 2 weeks.

Throughout the rest of your service the joint troubled you and you recorded 2 more visits for care to that limb. No further definitive treatment was done.

Some 2 or 3 years later your knee collapses under you and is excruciatingly painful. You see a physician and surgery is required.

You file for service connection for the disabling condition of the knee and the VBA denies that it is service connected.

As you decide to appeal the decision, you're told that to prevail you'll need a nexus letter. You seek out a physician to provide such a statement for you and the physician agrees that your current condition is probably a result of the injury in service. He or she may reasonably believe that at that time you had an injury that was not detected with routine x-ray imaging techniques but may have been obvious with MRI.



Reference: Veterans Name & Last 4 SSN

I am John Doe, M.D. and I have reviewed the pertinent military and medical records of the above named veteran.

I find that the veteran has evidence in his records of a knee injury on (date) during his military service.

The veteran is currently recovering from surgery to correct a (name) condition of the same joint.

It is my opinion that it is more likely than not that the current condition was caused by the original injury of (date).

I believe that it is highly probable that a more severe injury may have been identified then had a more diagnostic medical imaging technique like MRI been used.

I believe that the veteran will have a residual disabling defect of this joint that will result in a decrease of range of motion, a weaker limb than before as well as a scar of (describe).

You may contact me directly for more information as needed.


John Doe, M.D.

(Curriculum Vitae Enclosed)


A nexus letter should include only that which is required and no more. As in any communication to VA, excess words should be avoided.

Keep it simple and direct.

NEXUS Defined