NExus Letters all 50 States!
A Nexus Letter can Strengthen Your CLaim
What Is a Nexus Letter?
A nexus is a connection linking two or more things.
As it pertains to VAMC C&P claims, a nexus letter is a document that is written by a medical doctor that clearly describes how an in-service event caused the claimant’s current medical condition. A nexus letter can be added to your claims file as evidence and can improve your chances of being granted service connection or receiving an increase to an already service-connected condition.
You need a qualified doctor for your Nexus Letter
Is a Psychiatrist a Medical Doctor?
Yes!
Psychiatrists earn their M.D. after completing four years of medical school. This is followed by a one year medical internship that includes clinical work with internal and family medicine doctors in order to further learn how to diagnose and treat physical conditions. Next, psychiatrists complete another three years of residency training in the specialty of psychiatry. Psychiatrists are able to treat patients with both psychotherapy and medications. This blend of training makes psychiatrists uniquely equipped to write nexus letters. Psychiatrists have an incredible understanding about the pathophysiology of physical conditions, expert knowledge about the diagnosis and treatment of psychiatric conditions, and a supreme understanding of how psychiatric and physical conditions are interconnected.
Understanding Service Connections
Direct (Primary) Service Connected Conditions
A primary service-connection, is a condition that began while a veteran was on active duty.
Examples:
● You were deployed in a combat zone. While participating in combat operations, you were involved in life threatening events (i.e. received small arms enemy fire) and subsequently developed PTSD symptoms. Even if you didn't seek treatment for PTSD while in-service, you can still become service connected for Post Traumatic Stress Disorder.
●While in-service, you gave birth to a child. After delivery, you were diagnosed and treated for postpartum depression. Your depressive symptoms have persisted even many months or years after your separation from service. You can become service connected for Major Depressive Disorder.
● While deployed to a combat zone, your base was the target of frequent nighttime mortar attacks. As a result, you developed difficulty falling and staying asleep during your deployment. You continued to struggle with sleep even after your deployment ended and after separating from service. You can become service connected for Insomnia Disorder.
Secondary Service Connected Conditions
A secondary service-connected condition is an injury or illness that is a result of a direct service-connected condition.
Examples:
● While on active duty, you sustained a hip injury that resulted in you suffering from chronic pain. You are service connected for the hip injury. As a result of the chronic pain and the limits it has imposed on your life, you now suffer from depression. You can become secondarily service connected for Major Depressive Disorder.
● While on active duty, you worked in a MOS that exposed you to loud noises that caused you to develop hearing loss and tinnitus. You are service connected for tinnitus. As a result of the ringing in your ears, you now have sleep difficulties. You can become secondarily service connected for Insomnia Disorder.
Common Medical Conditions that Can Cause Psychiatric Conditions to Develop Include:
- Tinnitus
- Chronic Pain (from service connected injuries)
- Migraine Headaches
- Parkinson's Disease
- Sleep Apnea
- Stroke
- Erectile Dysfunction (ED)
- Female Sexual Arousal Disorder
- HIV/AIDS
- Hemorrhoids
- Most Types of Cancer
- Complications from Diabetes (i.e neuropathy, vision loss, dialysis, amputation, etc.)
- GERD
- Irritable Bowel Syndrome
- High Blood Pressure
- Chronic Kidney Disease
- Thyroid Dysfunction (Hypo/hyper)
- Traumatic Brain Injury (TBI)
- Multiple Sclerosis
- Uterine Fibroids
- **There are many other medical conditions that may qualify for a secondary psychiatric service connection. Having a nexus letter will be key! Dr. Allen will identify these conditions when she reviews your medical records.
Dr. Allen can also provide you with a nexus letter for a "Lifestyle Impact Claim."
Communication
- Our office is able to provide Independent Medical Evaluations (IME), Independent Medical Opinions (IMO), and/or nexus letters that meet VA-specific guidelines.
- If you are working with a lawyer or a veteran's representative, we can communicate and coordinate with them with your written permission.
- These evaluations are a one-time consultation examination and do not represent a formal doctor-patient relationship.
VA Disability Mental Health Ratings
We Provide Independent Medical Examinations (IMEs) for:
- Initial Mental Health Ratings (establishing service-connection)
- Mental Health Ratings Increases
- Mental Health Service Connections Secondary to Already Service Connected Conditions (i.e. depression secondary to tinnitus)
- Rebuttals for Proposed Reductions to a Mental Health Rating
- Individual Unemployability Claims Related to Mental Health (IU)
- 100% Ratings for Mental Health
- Permanent and Total Disability Letters
- Aid and Attendance Benefits and Housebound Allowances
- Character of Discharge Upgrades