VA Presumptive Conditions and Nexus Letters | All You Need To Know

Leah  explains whether nexus letters are needed for VA presumptive conditions. She breaks down what presumptive conditions are, referencing official VA sources like exposure to Agent Orange, burn pits, and Camp Lejeune toxins, and clarifies that these conditions are generally assumed by the VA to be service-connected, meaning a nexus letter is *typically* not required. However, Leah points out important exceptions, such as unclear service dates, denied claims, or secondary conditions, where a nexus letter might still be helpful. She emphasizes the importance of working with accredited VA representatives and gives practical advice for veterans navigating the claims process.

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At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.

The purpose of this channel is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey. 

Understanding the unique challenges veterans face our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim. 

Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.

⚠️ DISCLAIMER
This video is not medical or legal advice and should not be substituted for advisement from your VSO, accredited agent, or Attorney.

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Episode Transcript

Leah Bucholz (00:05):
Hey guys, it's Leah Bee from Prestige Veteran
Medical Consulting. I'm a USArmy veteran, physician
assistant and formercompensation and pension
examiner. So welcome back to thechannel. If you're a veteran
working through your VAdisability claim, you've
probably heard the term nexusletter before more than a few
times. But today we're answeringa very specific and important
question and that is, are nexusletters required for presumptive

(00:28):
conditions?
So let's break that down. Arepresumptive conditions? Give me
one second. I'm going to pull upva.gov's handy sheet here so
that you guys can reference it.Here we go.

(00:54):
All right, so va.gov'spresumptive 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, butspecifically I wanna look at
those presumptive conditions. Sothey're talking about Most times

(01:16):
when people talk aboutpresumptive things, they're
thinking about differentexposure related presumptive
conditions like for thoseVietnam veterans that were
exposed to Agent Orange or forthose veterans with PACT Act
related disabilities, eitherrelated to Agent Orange or
perhaps Gulf War service or CampLejeune, there's different

(01:37):
chemical contaminants, okay? Sohere you can see VA has a
hyperlink that talks aboutchemical 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.

(01:59):
Okay? So in each one of thesehyperlinks, can sort of see what
are the current conditions thatVA is accepting as presumptive,
okay? So I don't wanna gothrough every single one of
these, but I just want you guys,excuse me, to be aware of where
you can go to find them. Sova.gov has all of these

(02:21):
presumptive ones related toexposures to hazardous chemicals
and materials. They also havelong lasting illnesses that
appear within one year ofdischarge.
We have another great video thatI have done specifically on that
in the past becauseunfortunately a lot of veterans
think that you can be anythingthat comes up within one year is

(02:45):
presumptively related toservice. Well, that's not true.
So let me give you a couple ofexamples of why that would not
be true. But before I jump tothat, there's this POW one,
right? Also illnesses caused byyour time spent as a POW.
Okay, so let me jump off thescreen share. Okay, so
presumptive within one year, itmakes sense, right? So it has to

(03:06):
be something that reasonablywould have occurred while you
were on active duty, right? Wecan't just say like, maybe you
got out last month and you brokeyour leg today. Well, yes, you
broke your leg within one year,but that has nothing to do with
your service.
Right? Because you broke let'ssay you broke your leg in a car
accident or you broke your leg,falling down the stairs. Right?
So not every single conditionthat happens within one year is

(03:28):
related to service. So again, Iknow that's a really crazy one
to bring up, but it goes thatway for all of them.
So there's a specific list thatthey believe, one example is
arthritis. So if you've gotarthritis and you get diagnosed
with that like a month afterservice, it's pretty reasonable
to assume that that arthritisdidn't just grow over the past
month. That arthritis has beenthere for quite some time, at

(03:53):
least within a year, okay? Sothose are sort of some of those
presumptive items that we'regonna talk about today. So
again, a presumptive conditionis a medical condition that the
VA automatically presumes isservice connected based on your
military service history withoutyou needing to prove that direct
link.
Some of those common exampleslike we mentioned include Agent

(04:16):
Orange related conditions forVietnam veterans, Gulf War
illnesses, certain cancers fromCamp Lejeune and even conditions
linked to burn pits for thosepost nineeleven veterans. This
isn't all encompassing, okay? Soin these cases, VA has already
accepted that if you served in aspecific place during a specific

(04:36):
time and you have a certaindiagnosis, they're going to
presume that it was caused byyour service. So here's
question, right? Do you stillneed a nexus letter for
presumptive condition?
So the answer is usuallyprobably not. If your condition
meets the VA's criteria for apresumptive condition, you
typically do not need a nexusletter because the nexus or

(04:59):
connection between yourcondition and your service is
already assumed, right? Thatsaid, there might be some
exceptions. There might be someexceptions. So here is what a
nexus letter might still behelpful for a presumptive
condition.
Maybe you don't meet all of thecriteria. Maybe your service

(05:19):
location or timeframe isborderline or unclear. Maybe you
fall right outside of thattimeframe. VA denies your claim
anyways. Maybe it happens.
A strong letter might helpsupport your appeal. You're
secondary conditions. If thepresumptive condition caused
something else like depressionor sleep apnea, you may benefit

(05:40):
from a letter for that secondarycondition that's caused. So
that's not exactly presumptivebut if there's conflicting
evidence in your file, a medicalopinion can help clear that up.
So the bottom line for our mostclearly divine presumptive
claims, a nexus letter is notrequired.
A nexus letter is neverrequired, But in some cases it

(06:01):
can be the difference betweenapproval or denial, especially
if your case is complicated orif you're on appeal. So some of
those key takeaways again, nexusletters are not typically
required or even beneficial forpresumptive conditions. You
might still need one if thereare complications or secondary

(06:21):
claims. When in doubt, talk toan experienced VA accredited
representative, like a claimsagent, a VSO, an accredited
attorney, they should be able togive you feedback on your case
specifically. So if you havequestions on whether or not you
would benefit from one, again,to your treating provider.

(06:42):
They may be willing to supportyour case and write a letter for
you at little to no cost, yourVA provider. Again, they're
never required, but they cansometimes be helpful. You may
wanna talk to that accreditedclaims agent, va.gov has a list
of accredited representativesthat you can search and verify
their authenticity by the officeof general counsel. Are they

(07:05):
accredited to help you? Okay,that's always really important
that whoever's helping you withyour claim, file your claim,
appeal your claim is accreditedby those standards to help you
do that.
I am just a medicalprofessional, I work with a lot
of accredited claims agents,ESOs and attorneys that
represent claimants and I helpwith those nexus letters. Again,

(07:27):
you don't have to go to aservice like mine, you can
always get one, just a fewsentences even in your medical
record may be helpful. So I hopethis was helpful to you guys.
Please drop some comments and Ihope you guys enjoyed today's
video and let me know if there'sanything else you guys are
looking forward to hearingabout. All right, talk to you
guys soon.