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Is a Nexus required even with service medical record proof


Kraxup
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Question

I received a VA rating early last year for tinnitus and hearing loss. I recently started another claim for back pain, PES Planus(flat feet) and a ankle injury. I have proof in my service medical chart of a back injury on 2 occasion. Plus during the second visit it's document that my pain was continuous for the previous 6 months. 

The arch of my feet were recorded as normal during my first enlistment. When I reenlisted in the Army after being out of USMC for 4 months i recieced a entrance medical exam. In that entrance medical exam it's documented that i have flat feet.

 Lastly my ankle injury was documented in my service medical records. 

What is the opinion of getting a Nexus letter with so much proof in my service medical records. Get a Nexus, YES, or NO. 

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Well, yes.  Allow me a single example of why VA requires a nexus "even when" diagnosed with the disorder in service.  

Example:  You break your leg in service.  (As I did).  The doc puts you in a cast.  Many years later, I put in a claim for arthritis, because the fracture led to arthritis, and, eventually I had to have a total knee replacement.  

Did I need a nexus?  Yes.  I didnt have one and got denied.  In my case I did not appeal, in part, because the VA "never adjuticated" my knee issue claim.  

Yes, I could have fought the VA, but its "my opinion" that is moot now, because Im 100 percent plus SMC S, so an additional 30 percent (likely) wont increase my compensation 1 cent.  

So, I did not persue the knee issue claim any more.  

But the reason it was (deemed denied) (a "silent" denial) is no doubt because I had no nexus.  Of course, its a violation for VA to fail to adjuticiate because of 38 CFR 3.103, but again, it was not important to me.  

But..if you want SC, stick with the Caluza elements.  The VA will.  The only exception to the Caluza elements would be if your condition was presumptive, and its not.  

You get all 3 Caluza elements or you get denied.  Its that simple, and those are the rules.  Secondary SC, requires only 2...diagnosis and a link between your (secondary condition) and the condiiton to which you are already SC for.  

Save yourself time and money..just get the nexus.  Its not optional.  You have a better chance at winning the lottery than getting benefits without a nexus.  

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Look at it this way, when a veteran files a claim, VA is supposed to schedule him/her a C & P exam.  That C & P exam will basically say if the condition is military related or not.  Even though you were injured or were sick in the military, VA will not accept that as the cause of your condition until they get a medical opinion.  A veteran should never file a claim without a nexus letter or statement from a physician stating it is as least likely as not caused by or the result of their military service.  He/she would just be asking for VA to deny them or as Bronco said if the claim is for a presumptive condition and I have seen VA deny some of those claims.

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4 minutes ago, pacmanx1 said:

Look at it this way, when a veteran files a claim, VA is supposed to schedule him/her a C & P exam.  That C & P exam will basically say if the condition is military related or not.  Even though you were injured or were sick in the military, VA will not accept that as the cause of your condition until they get a medical opinion.  A veteran should never file a claim without a nexus letter or statement from a physician stating it is as least likely as not caused by or the result of their military service.  He/she would just be asking for VA to deny them or as Bronco said if the claim is for a presumptive condition and I have seen VA deny some of those claims.

Thank you! 

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20 minutes ago, broncovet said:

Well, yes.  Allow me a single example of why VA requires a nexus "even when" diagnosed with the disorder in service.  

Example:  You break your leg in service.  (As I did).  The doc puts you in a cast.  Many years later, I put in a claim for arthritis, because the fracture led to arthritis, and, eventually I had to have a total knee replacement.  

Did I need a nexus?  Yes.  I didnt have one and got denied.  In my case I did not appeal, in part, because the VA "never adjuticated" my knee issue claim.  

Yes, I could have fought the VA, but its "my opinion" that is moot now, because Im 100 percent plus SMC S, so an additional 30 percent (likely) wont increase my compensation 1 cent.  

So, I did not persue the knee issue claim any more.  

But the reason it was (deemed denied) (a "silent" denial) is no doubt because I had no nexus.  Of course, its a violation for VA to fail to adjuticiate because of 38 CFR 3.103, but again, it was not important to me.  

But..if you want SC, stick with the Caluza elements.  The VA will.  The only exception to the Caluza elements would be if your condition was presumptive, and its not.  

You get all 3 Caluza elements or you get denied.  Its that simple, and those are the rules.  Secondary SC, requires only 2...diagnosis and a link between your (secondary condition) and the condiiton to which you are already SC for.  

Save yourself time and money..just get the nexus.  Its not optional.  You have a better chance at winning the lottery than getting benefits without a nexus.  

Thank you! I haven't heard of caluza elements before. I'll take a look at that. 

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I agree with the advise given also. Based on what info you have provided, it should not be too difficult to get a nexus letter from your doc. You could submit and take a shot without it. In all probability, the VA will rule unfavorably on some or all of your claim  and then you can go out and get more evidence for supplemental appeal. That would be a new nexus letter. Save time and aggrevation; do it beforehand IMHO.

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