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No Nexus Letter for You!


bfd2100red

Question

I really don't like stirring the pot or razing a ruckus, but I this needs to be addressed at higher levels (VA Secretary, Congress, Senate...?) I am asking for folks input who should I notify of "our" issue?

So, like many of you, I have gone through the service connected process. I have had some successes, but this is the one shining example of why the VA IS NOT in the business of helping/assisting Veterans.

I have had a claim denied twice, and its currently awaiting placement of the docket at the board of appeals. There is ample medical evidence, buddy statements in support of my claim...but the single piece of evidence holding me back is "the nexus letter." I asked for assistance, and was denied. How is it that none of my VA doctors can write a nexus letter thus confirming that my disability is related to my service? Is every Veteran that receives care from the VA forced to seek outside medical opinions to satisfy the VBA nexus requirement? If that isn't a huge obstacle put on veterans ...I don't know what is?

With that, I secure messaged my VA primary care doctor and was told (in writing)..."None of the primary care MDs at the clinic are able or credentialed to evaluate patients for disability. The evaluation requires specific training and education. I'm sorry the Maplewood clinic could not assist you further with this evaluation.

 

I would love to get other people opinion on this systemic problem (I know I'm not the only one).

Thanks,

Nick

USA (RET)

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7 minutes ago, bfd2100red said:

I secure messaged my VA primary care doctor and was told (in writing)..."None of the primary care MDs at the clinic are able or credentialed to evaluate patients for disability. The evaluation requires specific training and education. I'm sorry the Maplewood clinic could not assist you further with this evaluation.

This statement is actually correct because you need to be referred to a specialist working in their particular field like a Neurologist, or an Internal Medicine Specialist, or a Rheumatologist or something.  I am not sure if you have asked for a referral but that is what you need to do. Also and very, very important you do not need a nexus letter a nexus statement in your progress reports stating that your condition is military related or secondary to a service connected condition should be acceptable.

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They the VA Dr's & Phyistrist told me its not there job...if I am filing a claim for comp  I need to go see the DAV...I said yes but there not Dr's&on one of my DBQ's it stated can be filled out by a VA phyiscian or VA LCSW Therapist  and they sill declined ...so had to pay for a private Doc.

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I could not find your prior posts here.

The denial letter will state exactly why they have not determined yet that you have established a "nexus".

" Is every Veteran that receives care from the VA forced to seek outside medical opinions to satisfy the VBA nexus requirement?"

No ,not every veteran.

It is difficult to determine what evidence they still need from you. Can you scan and attach the last denial here as to their "Reasons and Bases" and the Evidence list they used?

Cover C file etc prior to scanning it.

Many of us have had to pay big bucks for independent medical opinions.

It is a disgrace but so far nothing has been done about that. And never will be,in my opinion.

VA is supposed to weigh all evidence for and against a claim, but don't forget who owns the scale they use.

An IMO can be costly but is often the only way to succeed in many types of VA claims. The subsequent higher rating the IMO could generate, at some point, will cover and absorb the cost of the IMO.

 

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Berta,

I have been service connected sometimes without a nexus statement, but I also have conditions stuck up at the BVA due to no nexus or a non-VA provider not using them exact terminology the VBA requires.

With a laundry list of SC disorders (90%), medical studies, family and buddy statements...all painting a clear picture, I still get denied the condition (OSA), but specifically denying due to no nexus letter.

I am fortunate to have a full time job with medical benefits. I have both a VA and NON-VA primary dr's. I have had non-VA docs fill out DBQ's, and had to fight to get them recognized because the "real doctors" didn't know that only specialy worded terminology (least as likely than not) is the only language the VBA understands.

For me, the thought of a Vet going into this battle...VA dr's claiming that they can't assist a VBA claim is a huge hurdle placed in front of many veterans that they may never overcome. Maybe things will never change, but I'm at least going to be sure my elected officials are aware of what is happening and maybe they can champion for Us???

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What really stinks is when you have multiple entries in your SMRs dealing with the purported condition and the last one explicitly states that it is a recurring issue and contains other medical terminology as required by the rating system and they still deny you.

If I am not mistaken that there is what is called the "nexus" event.

But they get away by "consulting"an "expert" that waves their hands stating that they can ignore those facts when by regs the "benefit of the doubt" rule should have be applied.

But like Berta says, guess who owns the scales and who certifies that the scales are indeed accurate.

When you put the fox in charge of guarding the hen house.  The next day you don't exclaim; "where have all the chickens gone!?!" You politely ask; "did you enjoy your meal?"

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41 minutes ago, OldJoe said:

What really stinks is when you have multiple entries in your SMRs dealing with the purported condition and the last one explicitly states that it is a recurring issue and contains other medical terminology as required by the rating system and they still deny you.

Yes, this is what VA calls acute conditions. What you mean to tell me that my records show that I have been treated for this condition fifteen times in eight years and it is noted that it is recurring on several occasions and VA calls it acute,  Yep dumb jerks don't know what acute is.  Sorry, you are going to need that nexus statement my friend to win this one.

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