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Can you get a Nexus Letter from your VA doctor? Here's what you need to know about Directive 1134

If you've never heard of Directive 1134, you're going to want to read over this blog. Veterans preparing to file a claim for VA disability benefits should be aware of their options when compiling documents to support their claim, especially when it comes to Nexus Letters and other medical documentation. 


Here's what you need to know about Nexus Letters and what Directive 1134 means for your ability to get one:


First things first, what is a Nexus Letter?


A Nexus Letter is a medical opinion document to connect your condition to service or to another service-connected condition.  This medical opinion should be written by a licensed and qualified medical provider. 


But why is it so important? Well, this medical document contains valuable information that isn't typically written in treatment records. The information in Nexus Letters is presented in a way similarly to what is written in the 38 CFR (the VA's federal code of regulations that have to do with VA disability benefits awarding).


What is Directive 1134?


Simply put, VA Directive 1134 outlines the VA policy for doctors to fill out VA forms and write medical statements about their medical conditions and medical functionality. By getting familiar with Directive 1134, Veterans can leverage this policy document to their benefit by taking all available assistance regarding the VA disability claims process.


A few key components of Directive 1134:

  • It provides guidance for providers on how to complete medical statements and forms with examples

  • It requires every VA medical facility to have a contact person to assist veterans with these requests and handle issues related to completion of forms and medical statements

  • It provides instructions to VA doctors on how to complete DBQ forms


So, can you get a Nexus Letter from your VA doctor?


We'd love to give you a straight answer, but the honest one is that it's not so black and white. There are a handful of different factors that go into whether or not your VA doctor will write a Nexus Letter for you:


  • Knowledge of Veteran's condition (long-term doctor-patient relationships are beneficial!)

  • Whether or not the Veteran has sufficient documentation to support service-connection

  • The level of understanding the VA doctor has of Directive 1134

  • The doctor's medical opinion regarding the Veteran's condition

  • Any conflict of interest when it comes to providing their care


If you'd like to request a Nexus Letter from your VA doctor, the best way forward is to:


  • Gather and organize your documents 

  • Make sure to bring a printed copy of Directive 1134 - PDF available here

  • Make an appointment with your VA doctor

  • Come prepared with notes on your condition, symptoms, and they affect you

  • Follow up after your appointment

  • Get in touch afterwards either with your doctor or reception for updates


PS - If you got a Nexus Letter from your doctor but still got denied by the VA, read this blog.


If you can't get a Nexus Letter from your doctor, we have you covered


The most important thing about a Nexus Letter is that it's high quality, and thoroughly documents a Veteran's condition and medical history in VA-friendly language. We can help you get what you need to be prepared, whether it's a Nexus Letter, DBQ, chart review, or something else. Schedule a chart review or view our other services here. There's no need to navigate the often confusing world of VA disability benefits all alone – our professional medical experts are ready to support you through the process.



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