DISCLAIMER: This story is fictional and created for educational purposes only. The characters and situations depicted are not real. This narrative serves as an educational resource to help veterans understand the VA claims process and the importance of nexus letters.
The Frustration of Denial
Michael stared at the VA denial letter on his kitchen table, the frustration building as he read the phrase “insufficient evidence to establish service connection” for the third time. His knee throbbed, a constant reminder of that day in Afghanistan when his vehicle hit an IED. How could they deny something so obvious?
“Dad, can we play catch today?” his eight-year-old son asked, peering hopefully into the kitchen.
“Not today, buddy. Maybe tomorrow,” Michael replied, forcing a smile. The disappointment on his son’s face cut deeper than the pain in his knee.
Six years after separating from the Marines, Michael’s initial VA claim had been denied despite what seemed like mountains of evidence. His security consulting job had become part-time due to his worsening pain, and the child support payments weren’t getting any smaller.
“This is ridiculous,” he muttered, reaching for his phone to call Rodriguez, a Marine buddy who’d successfully navigated the VA system. “They’re saying I don’t have enough evidence. I sent them everything.”
Discovering the Missing Piece
“What kind of nexus letter did you submit?” Rodriguez asked after hearing the details.
“What’s a nexus letter?” Michael asked, embarrassed by his ignorance but desperate for answers.
“That’s your problem right there,” Rodriguez explained. “You’re missing the link that connects your current condition to your service. It’s not enough to have service records and a current diagnosis—you need an expert to connect those dots explicitly.”
Michael scribbled notes as Rodriguez explained the three pillars of every successful claim: in-service event, current diagnosis, and nexus. He had the first two but was completely missing the third.
Taking Strategic Action
The next day, Michael scheduled an appointment with a private orthopedic specialist, bringing his service records, current MRI results, and the denial letter. He explained what he needed: a medical opinion that explicitly connected his current knee condition to the documented IED incident.
“I’ve been treating veterans for fifteen years,” the doctor said, reviewing Michael’s records. “The VA needs to see the connection spelled out clearly. It’s not about what seems obvious—it’s about what’s documented with medical rationale.”
Two weeks later, Michael had a detailed nexus letter that specifically stated his meniscus tear was “at least as likely as not” connected to the IED incident, with medical reasoning explaining the progression of his injury over time.
Strategic Filing Decision
Rather than immediately appealing, Michael filed a supplemental claim with his new evidence. The nexus letter was the critical piece that transformed his scattered documentation into a coherent story that VA raters could follow.
Four months later, a new letter arrived. Approved.
The Impact of Success
That weekend, Michael played catch with his son in the backyard. His knee still hurt, but the relief from financial stress made the pain more manageable. The physical therapy and treatment options covered by the VA would help with the rest.
The Strategic Insight
“What made the difference?” asked his roommate, a Navy veteran considering his own claim, as they watched Michael’s son running in the yard.
“I was giving them pieces of a puzzle and expecting them to assemble it,” Michael explained. “But that’s not their job. The VA system isn’t designed to connect dots—it’s designed to verify connections that are already clearly established.”
The strategic veteran doesn’t just collect evidence—they connect it. A nexus letter isn’t just another document; it’s the bridge between military service and current disability that transforms scattered facts into an undeniable claim.
What connections in your evidence remain unestablished?
About the Author
Jerome Spearman is a VA Accredited Claims Agent and Legal Nurse Consultant specializing in helping Post-9/11 veterans navigate the disability claims process. After retiring from the Army, Jerome combines his military experience and healthcare expertise to educate veterans on strategic approaches to VA claims. Connect with him at jerome@spearmanappeals.com for personalized guidance.