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

[Whodat]

Applause to you. Good for standing up fighting on your feet instead of dying on your knees.

What is troubling me, I know that we need a nexus for a claim in order to get service connected. Where I am bamboozled at that if a vet is over 50%, they get medical treatment from their VAMC right, so if the Vet gets all of their treatment at the VAMC, shouldn't that be some type of nexus if they had an event or injury while in service?

 

[jamescripps2]

Providing a nexus for a condition and being treated for a condition are two different things. 

If the claim is for a presumptive condition, no nexus letter is required.

[broncovet]

James Cripps:

    I like the nexus letter you posted above, EXCEPT for one thing:  No start date.  Much better for your effective date is if the doctor included a statment, such as the one below"

    "Upon review of the medical records, the Veteran was first diagnosed and treated for (condition a, b, c, etc) on Jan 4, 2002."  

     Reason:  Your effective date is the later of the facts found (date the doc said you were disabled) and the claim date.  If you applied in 1998, but the doc said you did not get the disease until Jan. 14, 2023, then you will get an effective date of Jan 14, 2023.  

    Most often the VA uses "the date of the exam" if the doctor does not provide a date the disorder began.  Dont bamboozle your effective date, instead ask the doc to supply the date he thinks it started (not the exam date).  

Whodat:

    No.  50% service connection, and treatment at the VA will not provide a nexus for other conditions.  EAch condition must have a nexus to be service connected, and each requires the caluza elements.  Getting treated at VA (even if you are over 50 percent).  is not a nexus.  

[jamescripps2]

I had that base covered as I had already called and filed an intent to file while i was still in recovery in ICU to establish the EED.

There was no question about the start date as it is the day that I reported to the ER, barely alive, and the life saving emergency surgery was preformed.

Remember, that was not my first rodeo amego!

[broncovet]

Good.  But "our evidence", such as our phone calls, are not valid evidence for rating. 

It needs to be a doctors opinion, thus, that is why the date needs to be in the IMO.  

Hundreds of Veterans have wound up with the wrong effective date, and, at least part of that time,

is because the nexus writing doc, "did not include" a start date, but only a date of the exam.  

 

[jamescripps2]

This claim was a new claim filed on a 526EZ for Fournier's Gangrene. No matter what start date the doctor might state, the effective date, was going to be the date that the intent was submitted to the VBA.

If the claim had been for SMC, then yes, the EED would be the date of the onset. In that case a doctor's opinion should be considered by the rater.

That having been said. I needed to win that claim for Fournier's Gangrene and have it service connected quickly, because I was applying for the PCAFC caregiver's benefit in which they only consider service connected disabilities. From the date of filing until the date of the decision granting the claim took only 45 days.

Please note, I asked the cardiologist for an etiology of the disease, and he wrote one of the best nexus letters that I have ever seen. If he would have he opined as to a start date, it would have required pure speculation on his part. That nexus letter contained every component that is required by the VA in a nexus. If I had I asked the doctor for speculation as to a start date, I may have asked for more than he was willing to give and I would have walked away with nothing.

Bronco, we all are aware of how difficult it is to obtain a nexus letter from a VA specialist of that calliber. I did not need to stand on that doctor's coat tail and beg for a nexus letter to substantiate my claim. The letter might not have met your standards, but it met mine, and evidently it met the expections of the rater because it won me the service connection for the Fournier's Gangrene, an increase from SMC R-1 to SMC R-2, an increase from 0% to 30% for chloracne, 30% for three painful scars, and 0% each for eleven more scars. I applied and was granted level 2 caregiver's benefits.

In the shadow of all of that has been stated in the foregoing. After the claim for the Fournier's 

gangreen was awarded in 2020, my legal team immediately filed for an EED back to 2011 for the award of the R-2. That fuse has been lit and continues to burn, if I can only manage to outlive it!

Thanks for your input!