Do I need a nexus letter for every claim?

No. Some claims are granted without one, for example when VA presumes a connection for certain conditions and certain service, or when the link is already clear in your service records. A nexus letter matters most when VA says there is no link.

Can I write my own nexus letter?

No. A nexus opinion is medical evidence, so it has to come from a clinician qualified to give it. You can write a statement describing what happened in service and your symptoms since, and VA considers that evidence too.

Where do I send the nexus letter?

Submit it to VA with your claim, or with a Supplemental Claim if VA already denied it. Commander Health does not file claims for you.

Can Commander Health write a nexus letter for PTSD?

Commander Health reviews physical conditions only, so it does not write PTSD or other mental health opinions; for a mental health condition, ask your treating mental health provider.

How do I get a nexus letter for my VA claim?

Updated October 4, 2026

You can get a nexus letter three ways: ask your own treating doctor, ask your VA provider, or pay for a private review of your records. Whoever writes it needs your service treatment records and your current diagnosis, and the letter must state a clear conclusion and the reasoning behind it. Commander Health is a private, records-only option: a free screen first, then a licensed clinician reviews your file for a flat $500 and signs only if the records support the opinion.

Option 1: your own treating doctor

VA accepts a medical opinion from anyone "qualified through education, training, or experience to offer medical diagnoses, statements, or opinions" (38 CFR 3.159(a)(1)). A treating clinician who knows your history is often a strong author, and many write one at no charge or for a small fee.

Some decline for ordinary reasons: no time to read service records, an employer policy, or discomfort writing for a benefits claim. That is not a judgment on your claim.

Option 2: your VA provider

VA's own policy, VHA Directive 1134, lets VA providers who wish to give a medical opinion on causality do so, provided it includes a clear, specific rationale citing the evidence and standard wording such as "at least as likely as not." The same directive notes that VA providers often do not have your military medical records, so bring the in-service entries with you.

Option 3: a private records review

At Commander Health you upload your records for a free screen. If the evidence an opinion needs is there, a licensed clinician reviews your file and signs a nexus letter for a flat $500, records review included. Any follow-up question comes by email; there is no appointment. The clinician can decline if the records do not support an opinion, and you get your money back if we cannot complete your case. Commander Health reviews physical conditions only.

What to bring, whoever writes it

Service treatment records that show the in-service event, injury, exposure or illness.
A current diagnosis from your treatment records.
Treatment records that show the condition over time since service.
If VA already decided the claim: the C&P exam and the decision letter.
Your DD-214, to confirm your dates and branch of service.

What makes the letter usable

A rater weighs the reasoning, not the letterhead. A usable letter:

Lists the records the clinician reviewed.
States a clear conclusion in VA's terms, such as "at least as likely as not" (a 50% or greater probability).
Explains the medical reasoning that links the in-service event to the current diagnosis.
Addresses anything in the file that points the other way, such as a negative VA exam.
Is signed by the clinician, with their credentials.

Frequently asked questions

Do I need a nexus letter for every claim?: No. Some claims are granted without one, for example when VA presumes a connection for certain conditions and certain service, or when the link is already clear in your service records. A nexus letter matters most when VA says there is no link.
Can I write my own nexus letter?: No. A nexus opinion is medical evidence, so it has to come from a clinician qualified to give it. You can write a statement describing what happened in service and your symptoms since, and VA considers that evidence too.
Where do I send the nexus letter?: Submit it to VA with your claim, or with a Supplemental Claim if VA already denied it. Commander Health does not file claims for you.
Can Commander Health write a nexus letter for PTSD?: Commander Health reviews physical conditions only, so it does not write PTSD or other mental health opinions; for a mental health condition, ask your treating mental health provider.