What is a Nexus Letter

When you first file a VA claim or apply for VA disability benefits, the VA will require concrete proof or detailed information about your medical condition. It assists the VA in assessing your eligibility, determining your rating, and sending out the VA disability letter confirming your rating.

One of the biggest challenges veterans’ faces is proving the nexus, or connection, between their illness or disability and an in-service event.

This is where the Nexus letter becomes extremely significant. A well-written Nexus letter can greatly influence the success of your VA disability claim.

But what exactly is a Nexus letter, and why is it so important in the VA claims process?

The Importance of Nexus Letter in your VA Claims Process

As a verified veteran coaching service that understands the VA process, Just4Veterans and our VA claims assistance understand that supplying a medical nexus letter can help you achieve the correct rating. Some sample VA disability letters detail the exact condition you are experiencing.

A physician or other medical professional prepares a VA nexus letter, which details the relationship between a veteran’s medical condition and their military service.

It is extremely critical, especially for secondary health conditions, which are injuries or disabilities aggravated by military service.

For instance, years after sustaining a massive back injury during a training exercise that resulted in chronic lower back pain and a service-connected rating of 20%, the veteran starts to experience severe pain and numbness in their legs, leading to sciatica.

The veteran can use the nexus letter from their physician, along with the medical evidence of their sciatica diagnosis, to demonstrate the connection between sciatica and their original injury, in order to receive a higher rating and compensation. It serves as an objective medical opinion that explains the cause-and-effect of the veteran’s service-related injury.

Since it came from a verifiable source—medical professionals—a nexus letter helps prove your medical situation and persuade the VA to improve your qualifications to receive compensation. While it is not required, it establishes your medical condition and can make a difference in attaining approval.

If there are no medical documents to support your claim or if the Compensation and Pension (C&P) examiner cannot find any connection between your illness and your military service, you can submit a VA nexus letter with your initial application.

Obtaining a Nexus Letter

It is the veteran’s responsibility to obtain the Nexus letter, and although not required, it would be best to find a physician who knows exactly your condition and is familiar with the VA process.

However, if the physician or medical specialist refuses to write a nexus letter, you will need to find someone else. Unfortunately, writing a nexus letter is not a requirement for doctors; hence, they can refuse if a veteran ever requests one.

What Should You Include in Your Nexus Letter

While many doctors are still willing to assist veterans in this process, some may exhibit hesitation, which is why it is beneficial to draft one. This allows doctors to review, adjust, and sign, thereby saving them time.

In order to write one, you must include these essential elements.

1. The physician’s credentials

The doctor willing to write a nexus letter for you should include their name, credentials, specialty, and practice, and their medical establishment’s address.

2. Reference

A nexus letter should include a reference that confirms that the physician took the time to review your medical records and went through a treatment.

3. Medical Opinion

This is highly important because it provides information about your condition and how an in-service event created, affected, or aggravated it. It also offers information about your current health issues.

4. Medical Rationale

This includes citations to studies and medical research that support your doctor’s conclusion that your health problem is a result of your military service.

Sample Nexus Letter

Here’s a sample of a Nexus letter:

Note that this form is not for you to fill out. This is just a sample only. You need to personalize your letter, edit the following information, provide it to your physician, and finalize a signature. 

[Veteran’s Name]


[SS No.]

[VA File No.]


To Whom It May Concern,

My name is Dr. ______, and I am writing this letter in lieu of supporting the VA disability claim of [Veteran’s name]. I hold a position as a board specialist, with a specific focus on [specialty]. This letter includes my full credentials for your reference.

As the designated physician for [Veteran’s name] since [date], I can firmly affirm that my patient has received a diagnosis of [Medical Condition for VA Claim].

This diagnosis is confirmed upon thorough evaluation of the [Veteran’s Name]’s medical history, records and conditions including their VA file, military records, and [medical documents].

The [in-service event] in which [Veteran’s name] participated during their active service resulted in a massive aggravation of their medical condition.

Different medical examinations I conducted supported the connection between [indicating the veteran’s name, the military event he participated in, and his current medical condition].


[Name], MD


[Contact information]

[Medical office address]


John Doe

June 22, 2020

Veteran’s SSN: 123-45-6789

VA File No.: 0000001

ABC St., California, 8705

To whom it may concern,

I am Dr. Jane Doe-Smith, and I am writing this letter in lieu of supporting John Doe’s VA disability claim. I am a board specialist with a particular focus on neurology. This letter includes my full credentials for your reference.

Various medical examinations I conducted confirmed a link between John Doe’s training exercises and his severe back pain, which in turn caused pain and numbness in his legs, ultimately leading to sciatica.

I determined that John Doe did not participate in any other factors that may pose these risks.

Therefore, a thorough evaluation and my experience as a neurologist lead me to the conclusion that John Doe’s active duty in the military directly contributed to his current medical condition.

Feel free to contact me if you need further information or documentation regarding John Doe’s medical evaluation and condition, along with details on why I conclude that it is related to their active duty.


Jane Doe-Smith, MD


+1 840-000-1111

[Medical office address]

Submitting a Nexus Letter to the VA

You can then request that your physician sign and provide their credentials to support your claim.

The ideal process is to submit your medical nexus letter along with the initial VA claim. However, if you fail to provide that which resulted in your claim being denied, you can submit it with your appeal.

If you are confused and need proper guidance on this process, our coaching services can help. We provide accurate information on how to process your VA claims, obtain the most appropriate rating, and receive your compensation package. Feel free to book a free strategy call and contact our experienced veteran coaches directly. You may also visit our VA claims assistance page for more information.

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DISCLAIMER : Just4Veterans LLC is NOT an accredited agent, attorney, entity or VSO recognized by the Department of Veterans Affairs (VA) and is not affiliated with the VA in any way. Veterans shall prepare and file their own claim with an accredited representative, who may offer their services for FREE. Veterans may search for and appoint an accredited VSO.