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Nexus Letter Advice


VA and VA-contracted doctors typically “Will Not” write nexus letters supporting veterans’ claims for direct service connection. Although technically permitted to do so, VA generally discourages these doctors from opining on service connection. Doctors who do wish to provide medical opinions that state causality must include clear and specific rationale citing evidence to support the conclusion reached and should employ standard language appropriate for medical opinions (i.e., at least as likely as).

Since VA-contracted medical providers are considered to be hired in the service of VA, some are not medical experts for the purposes of writing nexus letters. They can, however, help veterans complete forms such as Disability Benefits Questionnaires. Private, non-VA doctors can complete nexus letters for a veterans’ claims for service connection. This includes private physicians and independent medical examiners. However, it is essential to note that not all nexus letters will be given the same weight or probative value; the VA can still deny your claim!


As of 2021, the average cost for a nexus letter is around $1,500 for multiple conditions; however, a nexus letter can cost more or less depending on the provider. If you have strong evidence that your conditions are service-connected, you probably do not need a Nexus Letter. However, you definitely need a letter if you are trying to prove that your condition is secondary to another service-connected condition or if you do not have substantial medical evidence to prove your service connection.

Advocates Note:

The VA Disability Advocate does not provide Nexus Letters; Nexus Reports are financial transactions between you and the company you chose to conduct the evaluation. The advocate, by law, is not permitted to accept monies for private assessments.

No proof, no benefits. The VA is required by law to have clear and definite evidence that a condition was caused by military service and no other cause before they can provide VA disability benefits. It is the veteran’s responsibility to provide that proof. A Nexus Letter is a strong form of evidence that can bridge gaps in a condition’s link to military service. Nexus Letters are essential for any condition not automatically considered service-connected. Conditions are automatically considered service-connected if 1.) there is ample evidence that it occurred during the veteran’s service or 2.) it is on the VA Presumptive List. The veteran meets the qualifications for the list.

The VA Disability Advocates Main Office is Located in Las Vegas, NV. We Represent Veterans throughout the United States. 702-209-5722 

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