Nexus Letter to support secondary disability

[MarineCombatVet70]

I have chronic pain caused from a service connected disability that has been rated.  I have treated this pain with otc pain meds for many years. I was recently diagnosed with GERD and Barrett's Esophagus that was caused from the otc pain meds.

I currently have a 90% total disability rating. I want to file a claim for this secondary condition.  I am going to ask the gastrointestinal doctor that diagnosed me to write a nexus letter,. Does his letter need to say that he reviewed all of my military records or is it good enough that he just acknowledges that I have chronic pain and taking otc pain meds more likely than not caused my Gerd and Barrett's Esophagus?

Thank you

[pwrslm]

I found that getting a nexus letter from a VA Doc is like yanking a leg off and donating to the red cross. Pointless and ineffective!!

I do seem to have good results getting them to list the etiology of my condition, including the cause, in my medical file. Just get him to attribute the pain meds that you use for your SC condition to the GERD/BE and its just as good as a nexus.

Your lay statements are sufficient to document that you take the OTC meds for your SC condition. Your Doc doesnt need to say that. You are competent to make that point.

[Gastone]

VA Dr's are required by VA Reg to complete an Issue Specific DBQ at or near the time of the Vet's Request. The only exception to this rule is for MH & PTSD DBQs. MH Psychiatrists/Psychologists are required to hand off the DBQ Request to a MH  Clinician that is not involved with the respective Vet.

Realistically, not all VA Drs are going to comply initially with the Vet's request for the specific DBQ. That's when the Vet pulls out a copy of the VA DBQ Directive and if need be, request Mast with the Department Head.        When any VMC Clinician Denies a Vet's legitimate request for any service, the Vet must push back by requesting politely, yet firmly, to see the Dept Head and/or requesting a copy of the VA Reg supporting the Clinician's Denial/Refusal of the Service requested.

[MarineCombatVet70]

9 hours ago, pwrslm said:

I found that getting a nexus letter from a VA Doc is like yanking a leg off and donating to the red cross. Pointless and ineffective!!

I do seem to have good results getting them to list the etiology of my condition, including the cause, in my medical file. Just get him to attribute the pain meds that you use for your SC condition to the GERD/BE and its just as good as a nexus.

Your lay statements are sufficient to document that you take the OTC meds for your SC condition. Your Doc doesnt need to say that. You are competent to make that point.

The doctor that is treating me and diagnosed my GERD and Barrett's Esophagus is not a VA doctor.

2 hours ago, Gastone said:

VA Dr's are required by VA Reg to complete an Issue Specific DBQ at or near the time of the Vet's Request. The only exception to this rule is for MH & PTSD DBQs. MH Psychiatrists/Psychologists are required to hand off the DBQ Request to a MH  Clinician that is not involved with the respective Vet.

Realistically, not all VA Drs are going to comply initially with the Vet's request for the specific DBQ. That's when the Vet pulls out a copy of the VA DBQ Directive and if need be, request Mast with the Department Head.        When any VMC Clinician Denies a Vet's legitimate request for any service, the Vet must push back by requesting politely, yet firmly, to see the Dept Head and/or requesting a copy of the VA Reg supporting the Clinician's Denial/Refusal of the Service requested.

The doctor that is treating me and diagnosed my GERD and Barrett's Esophagus is not a VA doctor.

[vetquest]

If this is not your VA doctor he must say he has reviewed all of your service records and C-file.  You can request a c-file through ebennifits but it may take up to a year.  There is also some other specific language that is required on the nexus letter such as he believes that it is most likely that your condition is secondary to your service connected disability.  Without specific language his letter would only be advice.  You could get him to write a letter and see what comes out in the C&P that will be required but that is not always a good choice.  The C&P could dismiss your doctor and then you would need an IMO (independent medical opinion), of course you might need an IMO anyway.

[Gastone]

M, are you receiving any VMC treatment for your Gerd & BE?

Your above post indicates a Non-VA Dr has DX'd and is treating your referenced conditions. How long have you been a patient of this DR, is he/she a Board Certified Gastroenterologist? You don't need a formal IMO or DBQ completed by this Dr. Copies of his/her's "Treatment Notes" are completely adequate for ALL VA Claims and Appeals.

With that said, it's your responsibility to steer the Dr towards discussing any and all possible etiologies regarding your conditions. No Dr, Specialist or PCP, is going to offer an etiology claiming he is 100% Certain that it's the only possible cause. The list of possible causes of Gerd and "BE" is somewhat extensive, the best you could probably do is an Opinion that 1 or 2 are more likely than the rest.

What has your Private Dr had to say regarding both conditions in question?

[Buck52]

13 hours ago, MarineCombatVet70 said:

I have chronic pain caused from a service connected disability that has been rated.  I have treated this pain with otc pain meds for many years. I was recently diagnosed with GERD and Barrett's Esophagus that was caused from the otc pain meds.

I currently have a 90% total disability rating. I want to file a claim for this secondary condition.  I am going to ask the gastrointestinal doctor that diagnosed me to write a nexus letter,. Does his letter need to say that he reviewed all of my military records or is it good enough that he just acknowledges that I have chronic pain and taking otc pain meds more likely than not caused my Gerd and Barrett's Esophagus?

Thank you

As long as this Dr is a Specialist in this field of medicine and has the credentials to prove so  should be good enough to render an opinion on your behalf...and that he REVIEWED & read the pertinent  medical records for this condition both VA and Private(name the condition) and examine you thoroughly   and use the words ''is likely as not''  he needs to go in detail about the OTC PAIN RELATED MEDICATIONS TOO OR AND IS LIKELY AS NOT CAUSED THE GERD AND BARRETT'S ESOPHAGUS  IN IS REPORT.

Or something close to this   remember the in Dr  opinion the ''IS LIKELY AS NOT ''those little 4 words will determine the outcome.