Nexus Sample Letters

[Sgt. Wilky]

Good morning,

I posted this a long time ago and will do it again. My local VSO sent these to me to as a sample for my doctors when it comes to writing letters for a nexus (link) letter from an event in service to a current a diagnosis. I've noticed several posts about this thing and thought it might be helpful to a few veterans.

Semper Fi,

Sgt. Wilky

NEXUS SAMPLE.PDF NEXUS SAMPLE #2.pdf

[jamescripps2]

Your VSO may have copied those for you but I actually wrote them and posted them on the United States Veterans Alliance site (USVA) web site in 2009. I wrote the two page examples in your first PDF attachment. I had nothing to do with the second PDF attachment and do not recognize it.I know that they were copied from our web site more than 5,000 times. I closed down the USVA website due to hackers in 2018 and transferred the Nexus letter documents to my web site where it can be found and copied today.

[Removed Link per Forum Rules]

I wrote those documents to be distributed far and wide in order for veterans to easily obtain their nexus letters. Thanks for helping in passing them along! It is indeed a small world!

Edited February 2 by brokensoldier244th

[Sgt. Wilky]

It apparently is! She sent them to me quite awhile back and I hope a lot of vets received help from them! Thank you for doing that!

Semper Fi,

Sgt. Wilky

[jamescripps2]

It is reasonable to think that if you ask a busy doctor for a nexus letter that they would refuse due to time restraints. On the other hand, If you mention a nexus letter, and then hand the doctor that two page request with the explination as to why you need the nexus, it would be considered later on outside of the busy office setting.

[jamescripps2]

My actual request to my cardioligist. for a nexus letter. I enclosed the example of a nexus letter and the PDF explaining why I needed a nexus as posted above in this thread by Sgt Wilky.

10/02/2020                                                             James M. Cripps,  last four ----

Dr. ---------, I remember in SICU, a doctor, most probably Dr Patrick -----, told me that the Fournier’s Gangrene was caused by a perfect storm resultant of my Diabetes, Chloracne, and the medication, Jardiance, that was prescribed for my Diabetes and heart disease. I understand that when Jardiance was prescribed, risk vs benefit was most probably considered. In my case, as you know, it didn’t work out so well. I ended up with Fournier’s Gangrene, a well known side effect of Jardiance.  As a result my life has changed and my abilities are now greatly diminished.

I now find myself needing to ask for your help. I need to show the etiology of the Fournier’s Gangrene. When I file a claim with the VA for service connection for Fournier’s as secondary to Diabetes, Chloracne, heart disease, and the prescribed medication, Jardiance, I am required by the VA to support the claim with a medical opinion as to the etiology.

I know that you are not a letter writer, but I am asking you to please consider writing this one, therefore enabling me to obtain my service connected benefits.

Also, the entire time that I have been assigned to the advanced heart failure clinic you have been my doctor. Because I have memory problems, my wife and caretaker, Sandra, has always, and still does, until Covid 19 restrictions, attend all of my VA appointments to get face to face instruction of any medication and/or treatment changes that you might offer. If you could vouch that Sandra, as my caretaker, does attend my appointments for the purpose of communication and interaction with you, it would greatly help me with my VA claim. That statement may require a separate letter.

Thank you for your consideration.

James M. Cripps

 

Edited March 21, 2023 by jamescripps2

[jamescripps2]

The following is my actual nexus letter as a direct result of my request. Upon submission of this letter I was granted SMC R-2.

DEPARTMENT OF VETERANS AFFAIRS TENNESSEE VALLE Y HEALTHCAR E SYSTEM

1310 24th Avenue South 3400 Lebanon Pike

Nashville, Tennessee 37212

5th October 2020

Re. James Cripps

Date of birth Jan------

To whom it may concern,

1 am Dr. -----------, a cardiologist, and Director of the Advanced Heart Failure and Heart Transplant program at the Nashville VA Medical Center. I have been asked to provide a statement in support of the afore mentioned veteran's claim. I have personally reviewed his medical records in the Computerized Medical Records of the Nashville VA Medical Center. I have also reviewed and have noted the circumstances and events of his military service.

Mr. Cripps has been under my care since June 2012. His diagnoses include an ischemic cardiomyopathy (heart failure with reduced ejection fraction and coronary artery disease), poorly controlled diabetes mellitus, chloracne and Fournier's gangrene. I am familiar with his history and have examined Mr. Cripps often while he has been under my care.

Mr. Cripps has no other known risk factors that may have precipitated his current condition. After a review of the medical records it is my professional opinion that it is highly likely Mr. Cripps' Fournier's gangrene is a direct result of his diabetes mellitus, chloracne and empagliflozin prescribed to treat his heart failure and diabetes. In my personal experience and it is known from the medical literature that diabetes mellitus is a risk factor for Fournier's gangrene; he was also predisposed to Fournier's gangrene by chloracne and the use of empagliflozin (a sodium-glucose transport protein 2 inhibitor or SGLT2 inhibitor).

Fournier's gangrene has been reported as a rare but serious side effect of SGLT2 inhibitor use (Bersoff-Matcha et al. Ann Intern Med 2019, 170(11);764-769.

Signed, Dr. ------------- Director, Advanced Heart Failure and Heart Transplant Programs. VAMC Nashville Tn.

[jamescripps2]

Thirty five years after my discharge from the Army, I began as a non service connected veteran and submitted my first claim in 2005. Along the way, in my seventeen year battle with the VA to obtain my benefits I required many nexus letters. I always looked the doctor in the eye and asked ,straight out and up front, for what I needed in order to support my claim. 

I managed to go from 0% to R-2 on my own, as a pro se veteran. Then with the help pf an attorney, I went through the Court for earlier effective dates of those awards.