My Claim was denied, can a Nexus Letter help me?

by | Nexus Letter

My Claim was denied, can a Nexus Letter help me?

You can strengthen the evidence in your appeal of a denied claim by using a nexus letter. The use of a well qualified expert to assist you in an appeal of your claim can strengthen the connection between your military service and your medical condition. The burden of proof is not insurmountable and your expert is offered as a neutral party reviewer of your claim.

Getting an Expert to properly support your claim in a Nexus Letter.

The burden of proof is not beyond a reasonable doubt, it is more likely than not. However, the burden of proof does need to be backed up with supporting evidence. The medical opinion does need to support that the burden of proof has been met and that it is supported by the medical evidence. This means that it is more likely than not (greater than 50% more likely) that the condition was caused by (or aggravated by) military service. The review of your medical documentation by a seasoned medical expert with a background in Veteran’s disability is beneficial in determining what supporting evidence makes this connection (or nexus).

Where should I start?

 If this is for your appeal of a denied claim, make sure you have all the relevant information from VA about why the claim was denied. Many times the lack of medical evidence from your Military Service is the reason. When you make the decision to use an expert then consider using a Doctor with U.S. Military and VA experience. By using a credentialed expert to review your medical records, you are more likely to find the supporting evidence that connects your claimed condition to your military service in a way that is more difficult to deny. The VA is required to give you the information that they have collected about your medical condition and any prior claims. This is called your Claim File or “C-File”. You can and should obtain a copy of your C-file. See references below for more information.

 

References

You can start the process of getting your VA records by going to https://www.va.gov/records/

How to get my DoD complete file https://www.va.gov/records/get-military-service-records/

VA records status can be checked here https://www.va.gov/FOIA/Requests.asp

Patient360.info url registration

Nexus Letter F.A.Q.

What needs to be in a nexus letter?

Things that need to be in a nexus letter:

1. Brief - it should be concisely focused on facts and conclusions.

2. Expert opinion - doctor with credentials. Our doctors have specialty board-certification and have prior military service.

3. Records review - connecting your condition to your military service requires review of relevant medical records and service records. The doctor will make a statement in the letter that they had access to, and were able to review these records.

4. Burden of proof - is more likely than not. The medical opinion does not have to be absolute. Remember the burden of proof is more likely than not that the condition was caused by (or aggravated by) military service.

5. Neutral party - the expert opinion of the doctor should remain honest and based on evidence. While not required, a recent examination of the veteran can add weight to the nexus letter.

I don't have any medical evidence that my condition occured in military service, can you still help me?

While it is important in cases for a veteran to submitted medical evidence in support of their claim, there can be other ways to link the condition to military service. This can be through eyewitness sworn statements, combat patrol reports and post-deployment health assessments among other ways.

My claim was denied, now what?

You can strengthen the evidence in your appeal of a denied claim by using a nexus letter. The use of a well qualified expert to assist you in an appeal of your claim can strengthen the connection between your military service and your medical condition. The burden of proof is not insurmountable and your expert is offered as a neutral party reviewer of your claim.

When is it too late to submit a nexus letter?
The Veteran can submit the nexus letter with their initial application for benefits, during the development of the claim are after the claim has been denied. Generally, it is best to submit a nexus letter earlier rather than later.
Why should I want a neutral party statement?
It is important that the VBA (Veteran's Benefit Administration) adjudicator find the medical evidence linking your medical condition to military service believable and this is best done by a neutral party.