Approval Of Nexus Letters (gerd Gastritis)

[mags1023]

I posted yesterday that I had won my claim. I got my envelope today and thought it might help some folks out to post how my letter reads and what the VA said about my NEXUS letters, so here it is:

For Hiatal Hernia/GERD and mild erosive gastritis as secondary connection for long term use of NSAIDs:

Your Dr. opined that the long term use of NSAIDs used to treat your arthritis and carpal tunnel "more likely than not" adversely contributed to your Hiatal Hernia/GERD and mild erosive gastritis.

In another letter dated...your family Dr. opined that your medications prescribed may have contributed to your condition. Your Dr. further stated these conditions are "at least as likely as not" related to your military service or the treatment of your service connected conditions.

The VA examiner opined that your Hiatal Hernia/GERD and mild erosive gastritis was not caused by NSAIDs (surprise, surprise ;) ).

Decision: Since the medical opinions of your private Dr's and the VA examiner are at "equipoise", reasonable doubt has been resolved in your favor and we have granted service connection on secondary basis. The opinions of the private physicians have been assigned more weight, as a rationale was provided with each opinion. The VA examiner did not provide a rationale.

So there you have it. All the experts on Hadit advised me to get these nexus letters from my Dr.s and they obviously were the key. I wrote the letters myself and had the Docs sign them when I was in their exam room. I can't imagine ever submitting anything without a NEXUS letter again. The wording could be a little stronger like use "caused" instead of adversely contributed. Hopefully, the doc will sign off on it.

I hope this helps some of you out there searching for the right words to say.

[mrmark1999]

coul.d you post the letter the doctor signed  so some of us could use it as a template?

[Gastone]

Obtaining an actual Nexus Letter from a Board Certified Specialist can't be beat, especially for the Vet on Appeal.  Not sure, but I've seen prices ranging from $1 to $1.5K discussed by Vets.

Hired Guns, cost. If it's a New claim, not on appeal, try the Free Version.

 Another Hadit Vet Todt and myself, probably many more, have been successful due to "Unofficial Nexus Letters" simply being placed in our treating Dr's (Both VA & Private) Clinician Notes. If your on good terms with your Treating Specialist, I've found that most are receptive to a discussion regarding your VA SC Claim and if the medical evidence supports your claim, will word their Clinician Notes so there can be no doubt as to the 50% or greater probability of your condition being SCd.

Back in 14, a VA C & P Dr actually completed another DBQ for me, regarding what we both agreed was the actual SC that caused the Secondary issue I was claiming. I told him I knew the 1st FDC was wrong and had filed a 2nd FDC within a month of the 1st.

He said he could only address the Rating Dept's request for a DBQ on the 1st FDC, But if I requested a DBQ regarding what we both agreed was the SC causing the Secondary issue, he would be obliged per VA Reg to complete my requested DBQ. I did, He did, 2nd FDC Awarded without an additional C & P Exam, 3 months later.

I'm sure not all Drs will be so obliging, but it's worth a try.

Semper Fi

[Guest]

4 hours ago, Gastone said:

Obtaining an actual Nexus Letter from a Board Certified Specialist can't be beat, especially for the Vet on Appeal.  Not sure, but I've seen prices ranging from $1 to $1.5K discussed by Vets.

Hired Guns, cost. If it's a New claim, not on appeal, try the Free Version.

 Another Hadit Vet Todt and myself, probably many more, have been successful due to "Unofficial Nexus Letters" simply being placed in our treating Dr's (Both VA & Private) Clinician Notes. If your on good terms with your Treating Specialist, I've found that most are receptive to a discussion regarding your VA SC Claim and if the medical evidence supports your claim, will word their Clinician Notes so there can be no doubt as to the 50% or greater probability of your condition being SCd.

Back in 14, a VA C & P Dr actually completed another DBQ for me, regarding what we both agreed was the actual SC that caused the Secondary issue I was claiming. I told him I knew the 1st FDC was wrong and had filed a 2nd FDC within a month of the 1st.

He said he could only address the Rating Dept's request for a DBQ on the 1st FDC, But if I requested a DBQ regarding what we both agreed was the SC causing the Secondary issue, he would be obliged per VA Reg to complete my requested DBQ. I did, He did, 2nd FDC Awarded without an additional C & P Exam, 3 months later.

I'm sure not all Drs will be so obliging, but it's worth a try.

Semper Fi

First, I really do not like responding to old post but this particular post is very important. The highlighted part is what I have been saying for years. Veterans have to build a good rapport with their medical doctors. It doesn't matter what the condition is, when a veteran is feeling the symptoms of his/her illness s/he must go and see their doctor.  The doctor need to see the veteran while the symptoms are going on making the doctor a witness of the fact that he/she (the Doctor) not only treats the veteran but has actually witnessed the symptoms and can be a very powerful ally in fighting VA red tape. Especially if the treating doctor is a VA doctor or a specialist working in his/her specific profession.

Edited March 6, 2016 by pete992

[Palma114]

Yea, Pete992,

you are right, Veterans have to build that rapport with doctors first, I found out the hard way about 10 yrs ago, I went in to see a specialist for a medical problem, that I was about to file a claim for, and I had medical records and I was trying to explain my medical problem and how it connected to other medical problems, and it just completely turn the doctor off,

he gave me a look like, I don't even know this guy, and he's been in my office for 30 mins and he already thinks I'm going write him a IMO.

After going back to the doctor on 2-3 more visits, and he did review my medical records, and he agreed with everything I had stated, because it was in my medical records, and all of his assessments was "most likely" on everything and a good rationale!

Edited March 6, 2016 by Palma114

[flores97]

Pete992 and Palma114, I couldn't agree more. I am very fortunate in having a good VA PCP, she goes above and beyond, BUT I never asked her to complete anything for me until I had gone into her office with full blown lupus flares, and at first she was actually somewhat standoffish, but after 6-8 months of somewhat tegular visits where i came in with these symptoms and always treated her courteously(and thanked her for the care), she has completely changed. Now, of course I believe she is the exception to the rule, but it hurts none to be as kind as conditions allow, docs are human like all of us and, unless they are just jerks, most will respond well after courteous treatment. Unfortunately there are also some that are not going to react favorably no matter how strong and obvious our medical evidence is, but for the most part after building a rapport with the doctor they are more inclined to help.

[flores97]

Mags1023, I know this is an old thread but thank you for posting this, I have gerd/hiatal hernia and IBS caused/aggravated by long term use of nsaids and this post gives me hope.