Wednesday, December 10, 2008

Doctors nexus letter in a VA disability claim.

Many veterans applying for veterans compensation benefits are aware that a nexus letter from their doctor can help prove service connection in their disability case. What I have found however, is that many nexus letters are inadequate and often times are given little weight by the VA. It is my personal opinion, that the VA relies too heavily on specific wording and other elements of the letter when determining what weight they will give that doctors opinion. But since the veterans administration is the one making the decision it is a good idea to try to include what the Veterans Administration is looking for in a nexus letter.

Oftentimes, the doctors that write these letters do not mention that they have reviewed the veteran's entire file and medical records. Believe it or not, this can be enough for the VA to disregard the doctors opinion. (This can also work to your advantage if you received an unfavorable C&P exam and the VA doctor does not mention that he reviewed the veterans file.) So if you're going to get an opinion letter from your doctor whether it be a nexus letter or an opinion of some other aspect of your claim it is important to give a copy of your file and any medical records you have to the doctor and tell him of the importance of him noting in his report that he has reviewed these documents. If the doctor references any thing from the file to support his opinion this can make the report carry even more weight.

For some issues, it is important that the doctor also perform an exam on you and state that his opinion is based on the veterans file, his medical records and his exam of you.

As I mentioned earlier, terminology can be very important in the nexus letter. You should let your doctor know that he does not have to be 100% sure in his opinion. You should provide him with the terminology the VA uses. Some examples are, if he is more than 50% sure he should use the phrase "more likely than not that the condition was caused/exacerbated during service. If he is 50% sure the terminology that should be used is "as likely as not that the condition was caused/exacerbated during service. If the doctor is less than 50% sure then the terminology that should be used is "less likely that the condition was caused/exacerbated during service. If a doctor is at least 50% sure (as likely as not) that your condition was caused or exacerbated during service then this is enough to demonstrate his opinion is that you are service-connected. More than 50% sure (more likely than not) is even better but not required.

Doctors opinion reports can be an extremely valuable tool in a be a disability claim if they are done correctly. If you have a lawyer or representative have them provide your doctor with a letter describing what is needed for your particular case. Every case is different and the type of report needed for a particular claim can vary so the above is just general information to give you an idea of what the VA is looking for. For additional information on VA disability claims or if you have any other questions you can e-mail me here or at the website linked in this sentence.