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Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities. Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Tuesday & Wednesday at 7AM Central.
Take control of your medical evidence related to your benefits and visit https://podcast.prestigeveteranmctx.info/veteran/ for more information and to connect directly with us!
Hey guys, it's Leah Bee from Prestige Veteran Medical Consulting. I'm a US Army veteran, physician assistant and former compensation and pension examiner. So welcome back to the channel. If you're a veteran working through your VA disability claim, you've probably heard the term nexus letter before more than a few times. But today we're answering a very specific and important question and that is, are nexus letters required for presumptive conditions?
Leah Bucholz:So let's break that down. Are presumptive conditions? Give me one second. I'm going to pull up va.gov's handy sheet here so that you guys can reference it. Here we go.
Leah Bucholz:All right, so va.gov's presumptive condition. So I am on, let's see, va.gov/disability/eligibility, okay? And so if we go down here, you can see there's a bunch of good information, but specifically I wanna look at those presumptive conditions. So they're talking about Most times when people talk about presumptive things, they're thinking about different exposure related presumptive conditions like for those Vietnam veterans that were exposed to Agent Orange or for those veterans with PACT Act related disabilities, either related to Agent Orange or perhaps Gulf War service or Camp Lejeune, there's different chemical contaminants, okay? So here you can see VA has a hyperlink that talks about chemical contaminants and they reference Agent Orange, asbestos, mustard gas, Camp Lejeune, radiation exposure, Gulf War Illnesses, Project one twelve, Gulf War Illnesses, there's just a ton.
Leah Bucholz:Okay? So in each one of these hyperlinks, can sort of see what are the current conditions that VA is accepting as presumptive, okay? So I don't wanna go through every single one of these, but I just want you guys, excuse me, to be aware of where you can go to find them. So va.gov has all of these presumptive ones related to exposures to hazardous chemicals and materials. They also have long lasting illnesses that appear within one year of discharge.
Leah Bucholz:We have another great video that I have done specifically on that in the past because unfortunately a lot of veterans think that you can be anything that comes up within one year is presumptively related to service. Well, that's not true. So let me give you a couple of examples of why that would not be true. But before I jump to that, there's this POW one, right? Also illnesses caused by your time spent as a POW.
Leah Bucholz:Okay, so let me jump off the screen share. Okay, so presumptive within one year, it makes sense, right? So it has to be something that reasonably would have occurred while you were on active duty, right? We can't just say like, maybe you got out last month and you broke your leg today. Well, yes, you broke your leg within one year, but that has nothing to do with your service.
Leah Bucholz:Right? Because you broke let's say you broke your leg in a car accident or you broke your leg, falling down the stairs. Right? So not every single condition that happens within one year is related to service. So again, I know that's a really crazy one to bring up, but it goes that way for all of them.
Leah Bucholz:So there's a specific list that they believe, one example is arthritis. So if you've got arthritis and you get diagnosed with that like a month after service, it's pretty reasonable to assume that that arthritis didn't just grow over the past month. That arthritis has been there for quite some time, at least within a year, okay? So those are sort of some of those presumptive items that we're gonna talk about today. So again, a presumptive condition is a medical condition that the VA automatically presumes is service connected based on your military service history without you needing to prove that direct link.
Leah Bucholz:Some of those common examples like we mentioned include Agent Orange related conditions for Vietnam veterans, Gulf War illnesses, certain cancers from Camp Lejeune and even conditions linked to burn pits for those post nineeleven veterans. This isn't all encompassing, okay? So in these cases, VA has already accepted that if you served in a specific place during a specific time and you have a certain diagnosis, they're going to presume that it was caused by your service. So here's question, right? Do you still need a nexus letter for presumptive condition?
Leah Bucholz:So the answer is usually probably not. If your condition meets the VA's criteria for a presumptive condition, you typically do not need a nexus letter because the nexus or connection between your condition and your service is already assumed, right? That said, there might be some exceptions. There might be some exceptions. So here is what a nexus letter might still be helpful for a presumptive condition.
Leah Bucholz:Maybe you don't meet all of the criteria. Maybe your service location or timeframe is borderline or unclear. Maybe you fall right outside of that timeframe. VA denies your claim anyways. Maybe it happens.
Leah Bucholz:A strong letter might help support your appeal. You're secondary conditions. If the presumptive condition caused something else like depression or sleep apnea, you may benefit from a letter for that secondary condition that's caused. So that's not exactly presumptive but if there's conflicting evidence in your file, a medical opinion can help clear that up. So the bottom line for our most clearly divine presumptive claims, a nexus letter is not required.
Leah Bucholz:A nexus letter is never required, But in some cases it can be the difference between approval or denial, especially if your case is complicated or if you're on appeal. So some of those key takeaways again, nexus letters are not typically required or even beneficial for presumptive conditions. You might still need one if there are complications or secondary claims. When in doubt, talk to an experienced VA accredited representative, like a claims agent, a VSO, an accredited attorney, they should be able to give you feedback on your case specifically. So if you have questions on whether or not you would benefit from one, again, to your treating provider.
Leah Bucholz:They may be willing to support your case and write a letter for you at little to no cost, your VA provider. Again, they're never required, but they can sometimes be helpful. You may wanna talk to that accredited claims agent, va.gov has a list of accredited representatives that you can search and verify their authenticity by the office of general counsel. Are they accredited to help you? Okay, that's always really important that whoever's helping you with your claim, file your claim, appeal your claim is accredited by those standards to help you do that.
Leah Bucholz:I am just a medical professional, I work with a lot of accredited claims agents, ESOs and attorneys that represent claimants and I help with those nexus letters. Again, you don't have to go to a service like mine, you can always get one, just a few sentences even in your medical record may be helpful. So I hope this was helpful to you guys. Please drop some comments and I hope you guys enjoyed today's video and let me know if there's anything else you guys are looking forward to hearing about. All right, talk to you guys soon.