Nexus Letters and VA Claim Denials
A veteran can receive a denial for a VA disability benefits claim even though their application included a nexus letter from a doctor. A nexus letter is a written opinion from a medical provider establishing the nature and severity of a veteran’s disabling condition and the condition’s connection to the veteran’s military service.
A nexus letter is often critical in determining whether your benefits application will be successful. However, it does not guarantee an approved claim on its own.
If the Department of Veterans Affairs has denied your VA disability benefits application even though a doctor provided a nexus letter, you still have options to seek approval of your claim. Veterans Guide can help with the next steps. We can connect you with an experienced veterans’ benefits attorney who can help you appeal the denial and represent you throughout the appeals process.
Common Reasons for VA Nexus Letter Claim Denials
The following are a few common reasons a VA disability claim may be denied even when the applicant has submitted a nexus letter:
Insufficient Medical Evidence
Some VA disability claims with nexus letters are denied because the doctor failed to clearly and thoroughly establish the nature of the applicant’s disability and how it resulted from the veteran’s service. The nexus letter must directly address all available medical proof of your condition, how your disability impacts your ability to work and function, and the event during your service that caused the condition. If any element of the nexus letter is weak or incomplete, your claim may be denied.
Lack of Credible Medical Expertise
Another common problem with nexus letters is the authoring doctor lacks credible medical expertise. This does not mean that the doctor is inherently a bad medical practitioner. Rather, it means they lack the necessary medical qualifications or expertise in the relevant specialty to treat your disability. For example, a nutritionist writing a nexus letter for lower back pain lacks credible medical expertise in the fields of spinal injuries, muscular conditions, and other problems that can lead to lower back pain.
Inadequate Evidence of Service Connection
Many VA disability benefits claims are rejected because the veteran cannot provide evidence of the event, injury, or illness during their service that caused or aggravated their disabling condition. You must prove that your disability is service-connected to qualify for disability benefits.
Provide the doctor writing your nexus letter with a complete service record, including any medical treatment you received while on active duty. Even the most detailed description of your daily symptoms will result in a denial if there isn’t enough evidence that your service caused the disability.
Technical Issues With the Nexus Letter
Technical issues with your nexus letter, such as missing documentation, application errors, and similar problems, may result in a claim denial. Of all the problems that can result in a claim denial, technical issues are typically the easiest to correct on appeal. Let the doctor who wrote your letter know about the problem and ask them to work with you to correct it to successfully appeal your initial claim denial.
How To Strengthen a Denied VA Nexus Letter Claim
After receiving a denial for VA benefits, you have a limited time to appeal your claim. While a licensed medical practitioner must write your nexus letter, you can do a few things as an applicant to strengthen your application on appeal.
Obtaining a Comprehensive Nexus Letter
If your VA benefits claim was denied despite a nexus letter, the issue often lies with the letter itself. The letter should thoroughly document your disabling condition and the doctor’s professional opinion about the connection to your military service.
When submitting an appeal of your benefits denial, obtain a comprehensive nexus letter from an appropriately experienced medical practitioner specializing in your condition. Your primary care provider may be able to refer you to a specialist who can provide a more informed perspective on your disability than a general practitioner.
Collecting Additional Medical Evidence
It’s critical to gather updated medical records, service treatment records, and diagnostic reports before appealing a claim denial. You must provide as much evidence of your disabling condition and its service connection as possible.
This process can be time-consuming and involve significant digging to seek out old records from various medical providers. Veterans Guide can connect you with an attorney to take on the heavy lifting of the appeals process for you. You can focus on coping with your condition while an attorney collects additional evidence to make your appeal as strong as possible.
How Do You Write a Strong Nexus Letter?
A compelling nexus letter is often the difference between a denial and an approval for VA disability benefits. A few factors add up to a stronger nexus letter and improve your chances of success on appeal.
Your nexus letter should be written in clear, professional language that spells out the nature of your disability and its connection to your service. It should also include strong medical evidence based on the doctor’s thorough review of your medical records, including your military service medical files, other existing medical records, and a physical exam.
Finally, the nexus letter must include direct statements regarding causation. The letter should explicitly say that the doctor writing it believes your service directly caused your disability and include their rationale. If your doctor is unfamiliar with the VA benefits process, you might want to seek a provider who has experience with nexus letters. Let your health care provider know the importance of the service connection when you initially ask for a letter.
When To Seek Professional Help
Receiving a VA benefits denial can be difficult, especially if you’re struggling to stay afloat financially while living with a service-connected disability. Working with a professional can take the weight of the application and appeal process off your shoulders.
A capable lawyer, such as the VA-accredited attorneys at Veterans Guide, will work with you directly to increase your chances of a successful appeal. Your attorney can help you gather evidence, connect with medical specialists, and receive a new nexus letter if necessary. Contact Veterans Guide today for your free consultation.
Frequently Asked Questions About VA Nexus Letters
Common questions we receive from veterans about nexus letters, claim denials, and appeals include:
What Is the Cost of a Nexus Letter?
Unfortunately, nexus letters aren’t free. Generally, you can expect to pay anywhere from $400 to $2,000 for a complete medical review and nexus letter. Factors that influence cost include the number of disabilities you have, how long ago you became disabled, and the extensiveness of your medical and service records.
Can I Appeal a Denied Claim Without a New Nexus Letter?
Yes, you can appeal a denied VA claim without a new nexus letter. However, you must gather all relevant medical records, all your service treatment records, and any available diagnostic reports to support your claim as much as possible.
What if My Doctor Refuses To Write a Nexus Letter?
Your doctor may refuse to write you a nexus letter for several reasons. You can try to find another doctor to provide you with a nexus record, particularly if you need a disability specialist.
If you cannot obtain a nexus letter, do your best to provide complete medical evidence in your application. Statements of support or “buddy letters” from colleagues, friends, and family can support your claim.
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