STEP 1: THE MEDICAL RECORD REVIEW
A Medical Records and VA Claims File Review is a comprehensive, structured analysis of a veteran’s service records, post-service medical records, and VA claims documentation to determine whether sufficient medical and factual evidence exists to support a legally and medically sound nexus opinion. This review includes an evaluation of service treatment records, personnel records, deployment and exposure documentation, VA and private medical records, prior Compensation and Pension examinations, rating decisions, denial rationales, and relevant lay evidence. The review focuses on identifying documented in-service events, injuries, illnesses, toxic exposures, or stressors, as well as post-service diagnoses, symptom continuity, functional impairment, and any evidence of chronicity, aggravation, or secondary causation.
The primary purpose of this review is to determine whether the evidentiary threshold required for a medical nexus opinion under VA standards is met. This includes assessing whether the medical evidence demonstrates a plausible pathophysiological relationship between military service and the claimed condition, whether alternative non-service-related risk factors are present and adequately addressed, and whether the available evidence supports a conclusion that the condition is at least as likely as not related to service.
This service is not a nexus letter and does not include the issuance of a medical opinion. Instead, it functions as a medical feasibility assessment to protect the integrity of the veteran’s claim and ensure that nexus letters are only pursued when supported by objective evidence, medical literature, and VA adjudicative standards. Veterans who are determined to be appropriate candidates may then proceed with a nexus letter, while veterans who are not candidates receive guidance on what evidence is missing, what development may be needed, or whether an alternative claim strategy is more appropriate.
The goal of a Medical Records and Claims File Review is to prevent unsupported nexus opinions, reduce the risk of VA denials based on insufficient rationale or evidence, and provide veterans with an honest, evidence-based assessment of their claim before additional medical opinion services are considered.
STEP 2: THE NEXUS LETTER
Our Nexus Letter service provides veterans with a comprehensive, evidence-based medical opinion addressing whether a claimed condition is at least as likely as not related to military service, secondary to an already service-connected condition, or aggravated by a service-connected disability. Each Nexus Letter is individually prepared by a licensed medical provider with extensive experience reviewing VA disability claims, Compensation and Pension examinations, and the evidentiary standards outlined in Title 38 of the Code of Federal Regulations.
This service begins with a detailed review of the veteran’s submitted records, which may include service treatment records, VA medical records, private treatment records, diagnostic studies, prior VA examinations, lay statements, and relevant supporting documentation. The evidence is analyzed to evaluate medical plausibility, timing of symptom onset, continuity of symptoms, progression over time, and recognized mechanisms of causation or aggravation supported by current medical literature.
The Nexus Letter is written in formal VA medical opinion format and includes a clearly stated medical conclusion using the VA’s required legal standard, a thorough medical rationale tied directly to the evidence reviewed, and citations to relevant medical research when appropriate. Each opinion is tailored to the veteran’s specific medical history and claim strategy and is structured to address common VA denial reasons, examiner deficiencies, and evidentiary gaps that frequently result in unfavorable decisions.
This service is appropriate for veterans filing initial claims, supplemental claims, higher-level reviews, or appeals who require a medically sound, defensible opinion to support service connection, secondary service connection, or aggravation. Nexus Letters are not templates or boilerplate documents but individualized medical opinions designed to meet VA evidentiary requirements and strengthen the overall claim. All Nexus Letters are delivered ready for direct submission to the Department of Veterans Affairs.
Frequently Asked Questions
A Nexus Letter is a medical opinion written by a qualified medical provider that explains the connection between a veteran’s current medical condition and military service or a service-connected condition. It addresses the VA’s legal standard of “at least as likely as not” and provides a medical rationale supported by evidence.
Who should consider a Nexus Letter?
A Nexus Letter may be helpful for veterans who have been denied service connection, are filing a supplemental claim, are pursuing secondary or aggravation claims, or whose prior VA examinations did not adequately address medical causation or functional impact.
Does a Nexus Letter guarantee VA approval or a specific rating?
No. A Nexus Letter does not guarantee approval, a favorable decision, or a specific disability rating. VA claims are adjudicated by the Department of Veterans Affairs based on the totality of evidence in the record.
What records do I need to provide?
Veterans are responsible for submitting all relevant records for review. This may include service treatment records, VA or private medical records, diagnostic testing, prior VA examinations, and lay statements. The strength of the opinion depends on the quality and completeness of the evidence provided.
Can you write a Nexus Letter without service treatment records?
In some cases, yes. Service connection may be supported through credible lay evidence, post-service medical records, and medically plausible mechanisms of injury or exposure. Each case is evaluated individually to determine whether a defensible opinion can be rendered.
