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How to Win Your PTSD VA Disability Claim with a Nexus Letter

VA Nexus Letter for PTSD. VA will pay disability compensation to a veteran if he proves his disability is related to military service.  As part of the process, VA uses disability nexus letters to figure out whether a disability was caused or aggravated during service.  If the answer is “No”, then VA will not pay for that disability.

Will You Need a VA Medical Nexus Letter for PTSD?

Not every VA claim needs a nexus letter because in some cases, the link to service is undeniable.  For example, if your service records include a diagnosed disability you still suffer from today, then VA would probably grant a claim for that disability without a nexus letter.  In claims for certain chronic conditions, VA will concede a relationship to service if there is a diagnosis within 1 year of discharge.


However, what if you don’t have a diagnosis until many years after service?  For example, Vietnam veterans with Agent Orange exposure usually don’t develop herbicide-related disabilities (such as diabetes mellitus type II) for several years.  The gap from discharge to diagnosis can be even greater with mental health disorders.  Many veterans respond to traumatic in-service events by trying to cope on their own.  Coping mechanisms include self-medication with drugs or alcohol, avoidance of medical treatment, and withdrawal from social situations.  When the symptoms get much worse and they finally seek mental health treatment, a doctor renders a diagnosis of PTSD.  To win this kind of claim, a strong disability nexus letter for PTSD is essential.

Who should Write Your VA Nexus Letter for PTSD?

Only a medical professional with the appropriate medical training should write a disability nexus letter.  In limited circumstances, non-doctors such as physician’s assistants and nurse practitioners can write them.  However, VA will find a disability nexus letter more persuasive if written by a doctor in the relevant specialty.  For mental health disorders such as PTSD, a psychologist or psychiatrist would be ideal.


From time to time, VA will ask affiliated doctors to write disability nexus letters.  However, most of those are not favorable to the veteran.  Give yourself the best chance to win by seeking an independent disability nexus letter.  If applicable, you should have your treating doctor write one.  That doctor is probably more knowledgeable about your condition than any of VA’s hired guns.

Requirements for a VA Nexus Letter for PTSD

VA will only accept a disability nexus letter if it meets certain requirements.  A strong disability nexus letter for PTSD must include:

  • A discussion of relevant medical history from service to the present day,
  • The likelihood that the PTSD was caused or aggravated during service, and
  • A reasoned explanation for the conclusion.

Medical History

The medical history from service to the present day is especially relevant to what caused PTSD.  Even the PTSD diagnosis happens years after service, the onset of the disability can be shown in service records.  Let’s say a veteran claims that racial harassment during service caused a persistent PTSD disability.  The service medical records don’t show treatment for PTSD.  However, the personnel records showed a drastic change in behavior 5 months prior to discharge.  His first 5 years of service included multiple commendations for performance.  In the last 5 months, he received multiple Article 15 punishments.  A good disability nexus letter would consider whether the sudden behavioral change marked the onset of PTSD.

How likely is PTSD related to service?

The burden is on the veteran to prove his claim.  However, the standard of proof is much lower than in a criminal case.  The doctor who writes the nexus letter does not have to be 100% sure of the link.  Because this is a veteran-friendly system, VA requires at least 50% certainty.  If your doctor finds there is at least a 50/50 chance that your PTSD is related to service, then that is enough to win.  In other words, a good disability nexus letter states that it is “at least as likely as not” that the disability is related to service.  A strong nexus letter would express “more likely than not” certainty.


A doctor is more likely to write a good disability nexus letter if PTSD clearly existed from service to the present day.  You can improve your odds by giving your doctor any of the following:

  • Your full service medical and personnel records,
  • Lay statements from friends and family who observed your behavior from service to the present day, or
  • Post-service medical and/or arrest records relevant to PTSD.

What is the doctor’s reasoning?

In a disability nexus letter for PTSD, 80% of the value comes from the doctor’s reasoning.  If the letter only contains data and conclusions, then it won’t help the case.  At a minimum, the reasoning must be clear, concise and supported by valid medical analysis.


For example, let’s say you are seeking a medical nexus letter for PTSD.  After reviewing your medical history, your psychologist agrees that “it is at least as likely as not that” your PTSD was incurred during your military service.  Her medical nexus letter should explain why the in-service symptoms and the post-service diagnosis matters.  It should also cite any medical literature that supports her opinion.  If there was any post-service trauma, she should explain how it only made the existing PTSD worse.

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Camp Lejeune Water Contamination is a Presumptive Service Connection

Camp Lejeune Water Contamination is a Presumptive Service Connection.
Camp Lejeune Water Contamination

Camp Lejeune Water Contamination is a Presumptive Service Connection. Veterans can claim certain illnesses they may have contracted in Camp Lejeune, even if they cannot connect the disability to the contaminated water. A Veteran may qualify by showing they were stationed at Camp Lejeune during the qualifying period of time and have an approved disability.

What is the presumptive service connection?

What is a presumptive service connection? A presumptive service connection assumes a link between the medical condition and the veteran’s service. Therefore, making it easier for a veteran to prove their Camp Lejeune service connected condition due to water contamination is service connected. The general rule requires the veteran to show the disability is connected to service in order to receive service connected compensation.

How to qualify for Camp Lejeune presumptive pay

Veterans may qualify for veterans compensation if they served at Camp Lejeune for at least 30 cumulative days between August 1, 1953, and December 31, 1987. It is very important to understand the rules that apply for the Camp Lejeune water contamination benefits because you may receive presumptive compensation.

Conditions that qualify for Camp Lejeune water contamination

  • Adult leukemia
  • Aplastic anemia
  • Bladder cancer
  • Kidney cancer
  • Liver cancer
  • Multiple myeloma
  • Non-Hodgkin’s lymphoma
  • Other myelodysplastic syndromes
  • Parkinson’s disease

Investigations showed contamination in the water

The investigators determined toxic contaminants existed in the water supply, therefore causing serious medical conditions. As a result the VA passed the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. In conclusion, veterans can receive presumptive compensation for Camp Lejeune water contamination.

Qualify for presumptive disability

You can qualify for presumptive service connection by showing a clean discharge record, served at Camp Lejeune during the required period of time, and if you have a listed condition. Service-Connected Diseases and Injuries Qualify Most Veterans for Disability Benefits. Veterans stationed at Camp Lejeune are eligible for presumptive compensation due to water contamination. In conclusion, Camp Lejeune water contamination is a presumptive service connection

Disability Help Group represents disabled veterans. If you have questions about your rating, benefits, date of onset, qualifying medical condition or other question, call us at 800-800-3332. Camp Lejeune veterans and family members can click here to talk to an expert on Camp Lejeune Water Contamination.

New Disabling Condition Linked to Agent Orange Exposure in Vietnam Veterans

It is presumed that nearly all veterans who served during the Vietnam War and were actively stationed in combat areas were exposed to Agent Orange at some point. The herbicide was so widely used that the Department of Veterans Affairs (VA) designated “Agent Orange presumptive diseases” associated with exposure to the defoliant chemical.

As more Vietnam veterans file veterans disability claims and join the Agent Orange Registry, VA doctors and research teams are learning more about the long-term effects of the deadly herbicide. Recently, researchers found an increased risk for a precursor to multiple myeloma, which is already among the conditions linked to the herbicide.

Monoclonal gammopathy of undetermined significance (MGUS) is a precursor disease to multiple myeloma, a type of cancer that attacks the plasma cells in bone marrow. A study reviewing 958 blood samples of U.S. Air Force personnel found that the personnel involved in Operation Ranch Hand were twice as likely to have developed MGUS than personnel not involved in the aerial spraying missions.

Of the 479 Operation Ranch Hand veterans, the prevalence of MGUS was 7.1 percent, compared to 3.1 percent in the veterans who did not participate in the operation. The cause of MGUS and multiple myeloma is still not largely understood. However, the findings of this and related studies involving farmers and agricultural workers has led researchers to suspect a link between pesticides and these conditions.

Disability Help Group Assists Vietnam Veterans Seeking Disability Benefits

The VA is still learning about new diseases and health conditions related to Agent Orange exposure. If you served during the Vietnam War in any capacity, there is a chance your disabling health conditions could be connected to Agent Orange exposure. Let The Disability Help Group review your military and medical records and help you file a veterans disability claim for benefits. Contact us at 1-(800)-800-3332.