What is a Nexus Letter?

Last updated: December 16, 2025

This guide explains what a nexus letter is, how the VA evaluates medical nexus evidence, and when submitting a nexus letter can strengthen your VA disability claim.

One of the biggest factors in a successful VA disability claim is proving how your condition is connected to your military service—and that’s where a nexus letter comes in. But what exactly is a nexus letter?

A nexus letter establishes the crucial link between your current disability and military service and is often the deciding factor in whether a claim is approved.

Whether you’re filing an initial claim, reopening a previously denied claim, or submitting a secondary condition, understanding how nexus letters work can dramatically strengthen your case.

Key Takeaways

• A nexus letter is a medical opinion that explains how your current disability is connected to your military service or to another service-connected condition. 
• A nexus letter must be written by a licensed medical professional, ideally one who specializes in your current condition. 
• You aren’t required to submit a nexus letter, but it’s frequently the missing link between an approved and denied VA claim. 

What is a Nexus Letter?

Nexus letters provide a clear medical link between your current diagnosis and your military service. 

It explains how an event, injury, or illness that occurred during your military service caused or contributed to your current disability. 

In simple terms, a nexus letter answers the key question the VA must resolve: “Is your current condition linked to your service?” 

To establish service connection, the VA requires three elements:  

• A current diagnosis 

• An in-service event or illness 

• A medical nexus (link) connecting the two (e.g., a nexus statement or nexus letter)

A well-written nexus letter provides that connection and can significantly strengthen your claim.

What is a Medical Nexus?

A medical nexus is the connection (link) between your disability and your service. 

A medical nexus is one of the required elements for your claim. Without evidence showing this connection, the VA may be unable to grant service connection even if you have a current diagnosis and a documented in-service event. 

Do You Need a Nexus Letter?

Every VA claim requires proof of service connection. This is often the hardest element to establish. 

The VA doesn’t require nexus letters, and not every claim needs one. Here are examples of when you may or may not need one. 

How to Get a Nexus Letter

The VA only accepts nexus letters written by licensed medical providers. You may know a licensed provider who could write your letter.  

If not, some services have expert providers who focus on VA disability nexus letters, such as Telemedica. 

Telemedica is a veteran-focused telehealth platform that offers medical nexus letter services with no appointment required, providing comprehensive chart reviews and quick turnaround times. 

Our services lead the industry because our providers know what the VA is looking for in a nexus letter. Most of our providers are veterans, military spouses, previous C&P examiners, or have worked for the VA. They know the lingo and quirks of the VA system.

Who Can Write a Nexus Letter

A nexus letter must be written by a licensed medical provider. Your letter carries even more weight when it’s written by someone with experience in the specific condition you’re claiming. 

Providers who can write a nexus letter include: 

• Physicians 

• Physician Assistants 

• Nurse Practitioners 

• Psychologists – Required for mental health–related nexus opinions 

• Any licensed medical provider with the appropriate credentials and clinical experience 

What Makes a Strong Nexus Letter

While nexus letters can vary, the strongest ones always include four essential elements: 

1. Clear Discussion of Supporting Evidence 
The provider should outline your medical records, service records, personal statements, and any other documentation reviewed that support your claim. 

2. Evidence-Based Medical Rationale 
The provider must explain why your current disability is connected to an in-service event, injury, or illness. Citing medical research, clinical guidelines, or studies strengthens their reasoning. 

3. A Clear Nexus Opinion 
The opinion must state the likelihood of service connection using accepted terms such as: 

1. “Is due to” – 100% certain 

2. “More likely than not” – greater than 50% 

3. “At least as likely as not” – 50% 

4. “Not likely due to” – less than 50% 

5. “Is not due to” – 0% 

The strongest letters typically use “is due to” or “more likely than not,” when supported by the evidence. 

4. Provider Credentials and Signature 
The letter must be signed and dated. The provider should list their full credentials, specialty, and any relevant experience to demonstrate their authority to give a medical opinion. 

How Much Does a Nexus Letter Cost?

The cost of a VA nexus letter can vary based on: 

• Case complexity 

• The provider’s expertise or specialty 

• How much medical record review is required 

You may be able to get a nexus letter at no cost from your treating physician. However, specialized medical opinions often come with additional fees.

Did You Know? You can get a credible nexus letter through Telemedica from anywhere worldwide. All you need is an internet connection.

Nexus Letter for Secondary Conditions

A nexus letter for a secondary condition is one of the strongest pieces of evidence you can submit. 

It shows that your secondary condition was caused or aggravated by your primary service-connected disability and gives the VA a clear medical explanation of how the two are connected. 

• Full article: Nexus Letter for Secondary Conditions 

Conclusion

If you need a nexus letter to link your current disability to an in-service event, injury, or disease, Telemedica can serve as your nexus letter provider. 

We can connect you with a licensed provider who understands your needs through our secure, private, and convenient platform. Contact us to get started.

Medical Evidence Wins VA Claims

Did you know that a lack of medical evidence is the #1 reason VA disability claims are denied?  

Medical evidence is a crucial piece of the puzzle that VA raters consider when reviewing a disability claim. Telemedica provides solutions for veterans looking to bolster their claims through high-quality medical evidence (such as DBQs and nexus letters) that win claims! 

Schedule your 20-minute consultation call and learn how to get the supporting medical evidence you need to strengthen your claim. 

FAQs | Frequently Asked Questions

What is a nexus letter for VA disability?

A medical nexus letter provides the expert medical explanation the VA needs to understand how your current condition is connected to your military service. 

What is a medical nexus?

A medical nexus is the documented connection between your current medical condition and your military service. It’s the professional medical opinion that explains how a service-related event, injury, or illness caused or aggravated the condition. 

Is a nexus letter required for a VA claim?

A nexus letter isn’t required and doesn’t guarantee service connection, but it can significantly strengthen your VA claim. You can submit one at any time, though submitting it with your initial claim is best because adding evidence later may delay the process. 

How do I obtain a nexus letter?

You can get a nexus letter from any licensed medical provider or from a service that specializes in nexus letters, such as Telemedica. Telemedica offers fast, no-appointment-needed nexus letters written by providers who understand VA requirements and the claims process. 

Who is qualified to write a nexus letter?

A nexus letter must be written by a licensed medical provider. Qualified providers include physicians, physician assistants, nurse practitioners, psychologists, and any other licensed medical professional with the proper credentials and clinical experience. 

Can I write my own nexus letter?

No. You can submit a personal statement, but only a licensed medical professional can write a valid nexus letter. 

Does a nexus letter guarantee VA disability benefits?

No. A nexus letter does not guarantee a favorable decision. It is considered along with your medical records, service treatment records, and other evidence. However, a well-written nexus letter can significantly strengthen your claim. 

Can the VA deny a claim even if I submit a nexus letter?

Yes. A nexus letter is considered supporting evidence but does not guarantee approval. The VA evaluates all your records, including service treatment records, C&P exams, and other medical evidence, before deciding. 

Related Articles

• When Do You Need a Nexus Letter for a VA Claim? 

• How to Get a Nexus Letter 

• Are There Nexus Letter Doctors Near Me? 

• VA Claim Denied With Nexus Letter?