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Nexus letter for Hives due to Toxic Exposures

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Hello all.  I am seeking any knowledge or advice on my current claim.  I conducted a video conference with a law judge on October 11th, 2019.  I am seeking a claim for chronic idiopathic urticaria(hives) that I've been battling for close to 28 years.  I conducted (2) Persian Gulf War clinical studies and evaluations at Walter Reed back in the early 90's.  The file acknowledges that I have this chronic illness but I lack a nexus letter or imo.  The judge found my testimony to be very credible and identified a treatment for dermatitis while I was in service.  I also sought medical treatment on the private side, Dermatologist, immunologist, and internist,  with the same chronic idiopathic classification.  I am looking to associate my illness to the toxic exposures and/or the initial dermatitis diagnosis that I received while in Iraq, Saudia Arabia and Kuwait. I've been given 90 days to get a imo/nexus letter from a dermatologist.  Essentially my question is do you know of a regional resource that would identify a good starting point for locating a Dermatologist who could assist with such a letter?  Any other points of advice?  Could medical hypothesis's be helpful?   

I was to associate my claim to the "toxic soup" some many articles refer to but how would I get a clinician to understand and render an imo for the skin illness VA is attributing to an Autoimmune disease.  One of my counter-questions was Autoimmune caused by?

Any help will be appreciated.


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There might be someone who could help here, depending on a search for the state you live in:


Or just by googling dermatologists in you’re a state might help- I say -in your state- because they would possibly want to do a full medical exam for their opinion. They willl need to have your SMRS and VA medical records, and they will need to follow the IMO/IME criteria here at hadit in that specific forum.

Also by doing a search at the BVA you might find a claim similar to yours that mentions a dermatologist in your state:


Often the BVA will only put a IMO doctor’s initials but that can narrow down the search ,in your state.The BVA does not put any state identifying info as to RO etc in their decisions, but past decisions still hold that info.

This recent BVA decisions holds the current ratings for this disability:

Unfortunately the veteran ( who received a “0” SC for hives ( better than a “0” NSC rating, did not fall into a rating higher than 10%  SC , even considering that the revised regulations for this disability.The reason for the appeal.***

The VA changed the rating schedule , during the past 28 years…so this is something the IMO/IME doctor needs ( (it is available here at hadit, under a search for Skin disabilities ----revisions of rating schedule.


*** Source :https://www.va.gov/vetapp18/files9/18133767.txt

Your problem if the hives are at a ratable level is the nexus- it is possible that a good IMO/IME doctor will find more evidence than the single entry you mentioned here:

"The judge found my testimony to be very credible and identified a treatment for dermatitis while I was in service"

The  phrase 'toxic soup 'or toxins in general is too vague for the VA.

What toxins can you prove, with your inservice  MOS, put you into exposure to those toxins and what specifically were the toxins?

That is a question a good IMO/IME doctor would need an answer to.And so would the VA.

You might need to consider getting a buddy statement too (info here available on Buddy states) and just about every Mil Unit has a web site, and many have reunion rosters or email for their members.

You have a lot to do, in a limited amount of time, but Nothing is impossible.

Also we have had vets here with skin diseases they were SCed for.Hopefully they will chime in.





Edited by Berta
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Hello Berta.  I appreciate you response and information.  I do have a buddy letter and also a letter and a letter from DoD acknowledging my exposure to chemicals from exploded exploded ordinance https://archive.defense.gov/news/newsarticle.aspx?id=16551 .  I would think this is relevant.  I have seen research moving towards associations of injections, pb pills, pesticides, etc. and illnesses from Gulf War service and skin conditions.  I'm hoping I can get this done before the Jan 9, 2020 deadline.


Thank You


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I read the letter from DOD - did you actually get a separate letter from DOD,  sent to you, stating you were exposed to chemical agents in Khamisiyah,Iraq and you were there at that time? March 1991.

The letter you posted starts out this way:


"WASHINGTON, July 27, 2005 – The Defense Department is again sending letters to thousands of Gulf War veterans exposed to low levels of chemical agents contained in munitions destroyed at a weapons depot in Khamisiyah, Iraq, in March 1991."

The Buddy letter, did they state they were in the same unit, same time and place where you served? Did they state their eye witness account of what chemicals you were exposed to? Did they give VA their full contact info,? as VA does often contact Buddys.

I hope you can find a good doctor who will prepare an IMO for you, as that can often take  some time.



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I am sadly of no help to you with your claim but also am battling this condition and it is absolutely awful!  On top of all of my other service connected disabilities it is literally the straw that may break this camel's back.  The VA is absolutely zero help in treatment, cause, sending me to any specialists other than an  allerigst ( hello, ZERO ALLERGIES)  so 8 claritin, xolair which the VA refuses to allow my community based care provider through the mission act to give and insists I be driven 6 hours round trip every two weeks to receive?  Yeah, yippeee go Mission ACT screw us again........ anyway I don't believe there is no cause, that is bs.  My primary care doctor did tell me to fast for 3 weeks on nothing but water and that would reset my system and that would cure me 🙄, my 20 year old was with me and told her she was out of her mind basically.  My neuro told me that I would end up in the hospital if I tried that for a week let alone 3, of course she never put any  of that in my actual medical records........because she wouldn't want to be held accountable.

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The VA revised it's Skin condition ratings in August 2018:

They are here:









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Hello Berta.  I did get a letter from DOD stating what the exposure.  I also read the new ratings for skin diseases.  I believe there is some language in the new ratings that mentions claim filing dates and if your claim will fall under the old rating or the new rating depending on the date of your appeal.  

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