Understanding Nexus Letters for Secondary Conditions
A nexus letter is a critical piece of evidence in VA disability claims, especially when dealing with secondary conditions. A secondary condition is a disability that resulted from or was aggravated by an already service-connected condition. To successfully claim a secondary condition, you need to establish a medical nexus, a link between your primary service-connected condition and the secondary condition you are now experiencing. A strong nexus letter, ideally from a qualified medical professional, provides this crucial link by offering a professional opinion explaining how the primary condition caused or worsened the secondary condition.
Key Components of an Effective Nexus Letter
A good nexus letter shouldn’t be vague. It should clearly state the medical professional’s qualifications, thoroughly review your medical history (including both service treatment records and post-service care), cite relevant medical literature supporting the connection, and express a clear opinion on the likelihood that the primary condition caused or aggravated the secondary condition. The stronger the wording (e.g., “more likely than not” or “at least as likely as not”), the better. Avoid nexus letters that use wishy washy language. The VA is looking for certainty.
Six Sample Nexus Letter Excerpts for Secondary Conditions
Please note that these are excerpts and should not be used verbatim. A complete nexus letter must be tailored to your individual case.
Sample 1: Sleep Apnea Secondary to PTSD
“Based on my review of Mr. [Veteran’s Name]’s medical records, including his diagnosis of service-connected PTSD and his subsequent diagnosis of obstructive sleep apnea, it is my professional opinion that his sleep apnea is more likely than not secondary to his PTSD. The chronic anxiety and hyperarousal associated with PTSD can disrupt sleep patterns and contribute to the development of sleep apnea.”
Sample 2: Peripheral Neuropathy Secondary to Diabetes (Service-Connected)
“Ms. [Veteran’s Name] has a service-connected diagnosis of Type II Diabetes Mellitus. Her current diagnosis of peripheral neuropathy, affecting her lower extremities, is at least as likely as not caused by her service-connected diabetes. Diabetes is a well-known risk factor for the development of peripheral neuropathy due to nerve damage caused by elevated blood sugar levels.”
Sample 3: GERD Secondary to Chronic Pain Medication
“Mr. [Veteran’s Name] is currently taking prescribed medications for chronic service-connected back pain. These medications, specifically NSAIDs, are known to irritate the lining of the stomach and esophagus. It is my opinion that his GERD is more likely than not directly related to the long-term use of these medications necessitated by his service-connected condition.”
Sample 4: Depression Secondary to Chronic Pain
“The veteran’s service-connected chronic back pain has significantly impacted his quality of life. He reports persistent pain, limited mobility, and difficulty performing daily activities. Based on my evaluation and review of his medical records, it is my professional opinion that his depression is at least as likely as not a result of his chronic pain condition.”
Sample 5: Migraines Secondary to Tinnitus
“The veteran has service-connected tinnitus. He reports frequent and severe migraines. Given the constant ringing in his ears and its associated stress and sleep disruption, it is my medical opinion, to a reasonable degree of medical certainty, that his migraines are more likely than not secondary to his tinnitus.”
Sample 6: Erectile Dysfunction Secondary to PTSD Medication
“Mr. [Veteran’s Name] is being treated for PTSD with [Specific Medication Name]. Erectile Dysfunction (ED) is a known side effect of this medication. It is my professional medical opinion that Mr. [Veteran’s Name]’s ED is more likely than not related to the medication prescribed to treat his service-connected PTSD.”
Conclusion: Strengthening Your Claim
Securing a strong nexus letter is crucial for a successful VA disability claim for secondary conditions. By providing a clear and well-supported medical opinion linking your primary service-connected disability to your secondary condition, you significantly increase your chances of receiving the benefits you deserve. Consult with a qualified medical professional familiar with VA disability claims to obtain a comprehensive and effective nexus letter tailored to your specific circumstances.