Claims help · Evidence
Nexus Letters: Your Questions, Answered
If your claim was denied for “no link to service,” the missing piece is usually a medical opinion called a nexus. Here’s what you need to know.
- What it is
- When you need one
- The 50% standard
- What the VA weighs
Thank you!
A member of our team will reach out within one business day to schedule your free case review.
What Is a Nexus Letter?
A written medical opinion explaining whether your condition is related to service, or to a service-connected condition, in the case of a secondary claim. It supplies the “link” that service connection requires, alongside a diagnosis and an in-service event.
When Do I Need One?
Usually when the connection isn’t obvious from your records, such as a back problem that started years after a training injury, or sleep apnea you believe is secondary to another condition. You usually don’t need one for presumptive conditions, like many PACT Act conditions.
What Does the VA Look For?
- The “at least as likely as not” standard (a 50% or greater probability)
- Evidence the provider reviewed your records
- Reasoning that explains the conclusion
- Engagement with any negative VA opinion
Hedged language like “possibly” or “could be” usually carries little weight.
Nexus Letter Q&A: Common Questions
Who should write my nexus letter?
A qualified provider familiar with your condition, often your treating doctor, psychologist or a specialist.
What does “at least as likely as not” mean?
A 50% or greater probability that the condition is related to service. It’s the VA’s benefit-of-the-doubt standard.
Can I submit a nexus letter after a denial?
Yes. A new medical opinion is common new and relevant evidence in a Supplemental Claim.
Is the VA required to consider my private opinion?
Yes. The VA must weigh it with the other evidence, and a well-reasoned opinion carries significant weight.
Kansas Veterans: Get the Rating You Earned
Start with a free, no-obligation case review. It takes about a minute.