Nexus Letters

What is a Nexus Letter?

A “nexus” is a link or connection between two or more things. The purpose of the NEXUS letter is to make the connection between your (the veteran's) current medical condition and either a service-connected condition or to an event related to your military service.

Ideally, a nexus letter would come from your primary care physician. But in most cases, especially if the VA is treating you, this is not feasible. Why? Because VA doctors are generally dissuaded from writing nexus letters or giving any opinions about the service connection of your condition. Also, many private civilian healthcare providers are unwilling to write nexus letters because they do not understand the VA system.

When is a Nexus Letter Necessary

Nexus letters are essential for any condition that isn't automatically considered service-connected, so if there is not ample evidence that it occurred during your service or on the list of presumptive illnesses (that you meet the qualifications for).

Nexus letters are also essential for secondary conditions (conditions caused by a primary service-connected condition) - because the letter will need to state clearly how the primary condition causes the secondary condition.

Nexus letters can also be beneficial after a negative C&P examination, especially if the examiner found no evidence between the claimed condition and your military service.

In PTSD and other mental disorders, a nexus letter can be an excellent way to connect the disorder to the event during your military service that caused the disorder. It is important to show that your military service was the main cause of the disorder, and a good nexus letter can do this.

You can also use nexus letters for conditions that develop more than a year after separation but were caused by exposure to chemicals, noise, medical treatments, or other circumstances in the military. If a condition is not on a presumptive list or the noise exposure list, it is up to you to prove the connection.

Until the chemical exposures at K2 are considered presumptive, we will need to rely on Nexus letters to make the case that the chemicals present caused the conditions reported by K2 Veterans.

How do I get a nexus letter?

If possible, getting a nexus letter from your primary care physician is preferred. But usually, this is not going to be an option.

If you retain an attorney, they may have a doctor contracted to write nexus letters for them. Some VSO's have doctors they know in the local area that are willing to provide the service to veterans. If these options are not available, there are quite a few companies whose sole function is to perform records reviews, write Nexus letters, and complete DBQ's. Some of these companies can charge thousands of dollars for a nexus letter.

The Stronghold Freedom Foundation (SFF) has an agreement with Valor 4 Vets to help K2 Veterans get records reviews, nexus letters, and other documents they may need to fight the VA.

SFF also raises money to help K2 Veterans that cannot afford to pay for a nexus letter or records review. If you need assistance getting a records review, nexus letter, DBQ, or any help with your VA claim. Please contact us. We may be able to assist you.

noun: nexus; plural noun: nexus; plural noun: nexuses
  1. a connection or series of connections linking two or more things.
    "the nexus between industry and political power"


  1. Anthony Chapa on September 2, 2021 at 12:32 am

    What is a K2 Vet?

    • sarah on September 6, 2021 at 7:34 pm

      A K2 Veteran is a military service member who was stationed at or transitioned through Karshi-Khanabad, Uzbekistan (aka Camp Stronghold Freedom). The Veteran’s Administration requires proof of service or anecdotal evidence that you were there. For Civilian Contractors – who SFF also considers K2 Veterans, but who are not covered by the VA – we have a civilian attorney that has agreed to review their cases.

      I hope this answers your question.

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