How to get civilian doctor to write a letter of support

[Dustin]

How to get civilian doctor to write a letter of support that a medical condition is likely do to military (i.e., psoriasis)? This is for a va disability claim.

[broncovet]

You ask him to do so.  Not all doctors would be interested, or would do so, but some specialize in things like Independent medical opinions.  

One way to ask.  "Do you think, Dr. Jones, that (this condition) could have been caused by my

( in service event you allege caused your disability)?  If he responds yes, that could well have led to your current diagnosis, then ask him to write it down and document it.  

Further, you can explain that VA needs this in THIS format:  Example

The Veterans (knee arthritis) is at least as likely as not due to a knee fracture the Veteran reports he had during military service.  (now list a medical rationale, such as a medical study showing that knee fractures often lead to arthritic knees).  

You can ask your doctor to include his CV, and send this relevant evidence (nexus) to VA.  

Remember, YOU are paying the doctor bill, so you can ask him to do things for you like this.  When VA pays your doctor bill, then the doctor is more likely to "answer to " the  person who signs his checks, so they may be reluctant to do so.  

But he works for you, because you pay him.  

[jamescripps2]

I have a written request to give to your doctor along with a sample nexus letter for the doctor to use as a templet. It has been cut, pasted and copied thousands of times in the last fifteen years for use in obtaining a nexus letter. google search

vatheredneckway.wordpress.com

[Whodat]

Like all stated above, the squeaky wheel gets the grease. Some of the elder Hadit members like rattle recommends that you prepare your own letter and provide supporting documents, who knows, may work.

[Rattler]

I have included an example of a Nexis letter below. It is for sleep aperea but it tells how to do one. Whodat is right you will need a copy of your military medical records for the Doc to review and he needs to state he reviewed them in the letter.

  

Example of Private Dr opinion MEdObese.pdf

[jamescripps2]

 Copy and paste to Print the 2 pages (Nexus explanation & example Nexus)  Submit to your doctor.

Page 1

There are certain important things in this world that we only get one shot at. Such is the Nexus letter in a veteran’s service-connected disability claim with the Department of Veterans Affairs. Although only one Nexus letter is required, it is advisable to seek the overwhelming number of three individual and concurring Nexus letters if possible. The Nexus letter may require a lot of effort on the part of the veteran, but the return is indispensable.

Generally, according to the law, three elements are necessary and therefore required to obtain a favorable decision by a veteran for service-connected benefits.

#1- An event in service that could have caused or aggravated a disease or condition

#2- A present day diagnosis of the existence of the same disease or condition

#3- A medical opinion linking number 1 with number 2

The required medical opinion is called a Nexus letter. The letter must be written specifically for the individual and explicit to that individual’s claim. It is important that the opinion be expressed as a degree of likelihood. The degrees of likelihood, arranged in ascending order from the lesser to the greater are as follows, “not likely”, “at least as likely as not”, “more than likely”, “and highly likely”.

In the case of “at least as likely as not”, the veteran always receives the benefit of doubt and therefore the outcome is considered a favorable opinion. The doctor, or expert, does not have to use absolutes or conclusions in the statement. Opinions are gleaned by a review of the pertinent records and facts. A professional opinion can then be rendered based upon the record, the medical history, the facts, and the education and/or experience of the author of the letter.

Most denied veterans’ claims failed because of the lack of a Nexus letter altogether or the lack of a properly written Nexus letter.

A proper Nexus letter must be as brief as possible while stating the facts and must include the following:

“After a review of the veterans pertinent records” – (use medical and any service records furnished by the veteran to show the event in service)

“It is my professional opinion that it is at least as likely as not” – (choose and insert the proper degree of likelihood, see above choices)

The author must offer a rationale as to the opinion in the statement – (e.g.,” It is well known in medical journals”)

The author must provide credentials, especially VA titles or specialties – (e.g., Oncologist, Hematologist, Orthopedic Surgeon, Environmental Clinician, etc.)

Please understand that the VA often uses credentials to assign probative value to the nexus letter.

Example of a Nexus Letter

DATE ____________

Reference: (Veteran’s name) ____________

SS# ____________________ VA File #____________________

********************************************************************************************** Page #2

To Whom It May Concern,

I am Dr. ____________. I am board certified to practice in my specialty. My credentials are included. I have been asked to write a statement in support of the afore mentioned veterans claim.

I have personally reviewed his medical history. (Name the Documents) I have also reviewed and have noted the circumstances and events of his military service in the years ____________ (Event or Events claimed as the cause of the condition) while he served during his military service. (List dates of service)

Mr. ___________ is a patient under my care since (enter Date). His diagnosis is _____________ (Name the Condition).

I am familiar with his history and have examined Mr.____________ often while he has been under my care. (Specify Lab Work, X-rays, Etc.)

Mr.____________ has no other known risk factors that may have precipitated his current condition.

After a review of the pertinent records it is my professional opinion that it is at least as likely as not that Mr. ____________’s condition is a direct result of his (Event) as due to his military service. (Choose the degree of likelihood with which you can concur – “at least as likely as not”, “more than likely”, or “highly likely”)

In my personal experience and in the medical literature it is known (Give a rationale).

Signed,

Dr. ____________
(List credentials and contact information)

Please understand that the VA often uses credentials to assign probative value to the nexus letter.
While the nexus letter must be brief as possible it should be as detailed and complete as the circumstances dictate.

[broncovet]

This is fine and good..have a sample nexus statment.  However, Doctors often have big egos, and many dont like being told what to do.  

I advise "asking" them if they are familiar with the "VA format" for nexus statments.  Wait for their response.  They may well have provided a nexus in the past, and, if so, dont tell them what to do.  

However, if they indicate that they have not done a nexus for VA, then offer them a "template".  

That is my advice.  

First, before all this, I ask, "Do YOU think (your diagnosis) is likely to be caused by (name in service event you allege caused it).  

I asked the doc if she thought my TKR (Total knee replacement) was "bone on bone" from degenerative arthiritis from an in service knee fracture.  

She responded in the negative. I was pretty suprised.  It wound up being moot, however, as I really dont need any additional sc disabilites.