Often times I will see a veteran get denied disability compensation because they lack the nexus element of their claim or worse the VA has hired a doctor to provide one and that opinion is against the veterans claim. For one reason or another too many veterans are being denied because they lack a good nexus
opinion. In this piece I will break down the good elements of a nexus opinion how to obtain one and how to avoid scams that unfortunately do exist.

First, let’s discuss what a nexus is. A nexus is a medical opinion provided by a doctor that states that your disability whatever it may be is related to your time in service. Seems simple but if your nexus is simply “I believe condition A is related to event B in service” then be prepared for a denial. That is because the crucial part of any nexus is the rational or reason why the above statement is true. Another fact that I should add is that the term “at least as likely as not” is crucial to the opinion it is not enough for a doctor to say something like it is possible or probable or even likely that disability A is related to event B. This is because the VA prefers its own language and will discredit any opinion that does not
include it.

Now let’s get into the element of a good rational before we do let’s take a look at a case I like to review before I take a look at any nexus to refresh my memory on what it means to have a good rational. The court found that guiding factors in evaluating the probity of a medical opinion are whether the opinion was based on sufficient facts or data, whether the opinion was the product of reliable principles and methods, and whether the medical professional applied the principles and methods reliably to the facts of the case. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). This case basically tells me the most important elements in any rational. So the first major item would to
me be sufficient facts and data. This to me means that the doctor is citing to medical journals that explain how the condition could be related to service. For example let’s say a veteran with a lumbar spine condition (low back) who lets say fell in some awkward way and hurt that back but never complained other than on the day of the injury. A good doctor would know where to look for positive studies showing that such a back injury had occurred that there would be long term detrimental effects on the lumbar spine. Another important element of the facts and data is the facts of your case. For example are you someone who just took the pain for years ignoring it and now when you really need
the disability are being told no because it’s been to long between you seeking service connection and your time in service? Well if that is true then the doctor you hire needs to be able to address that because if they do not it will diminish the probative value of your nexus. Some people will say but how does one prove that they still had a disability for all those years if they never sought treatment? The
answer is through buddy statements and personal testimony. VA has a rule that states lack of continuity of treatment after service cannot be a bar to service connection if the veteran can develop sufficient lay
evidence to suggest that the condition continued.

Now we will also get into principles and methods element to me this means is your doctor using the facts and data correctly. For example if your doctor cites medical journals that show that sleep apnea is not caused by PTSD but then draws the conclusion that it is then are they using correct principles and methods? I would say that they are not and I would say this would also be true for the applying correct principles and methods to the facts and data in the case. I do not want to go into too much detail on a good rational but hopefully this will help you have a better understand of what you are looking for. So I
encourage all veterans, if you get a nexus for your case make sure you read it before the doctor submits it on your behalf or before you do. You might not be a legal and or medical expert but you are still an expert on your own experience and deserve a voice in what is said about your disability. This is another
great reason to hire an attorney such as Karl Kazmierczak for your representation. A VA attorney will read and edit a nexus provided to them providing feedback to the doctors before accepting any nexus. This is something that you can do on your own but that is likely better coming from a legal professional with years of experience as doctors are more receptive of lawyers input and lawyers better understand
and can break down the law for a doctor.

So the next thing to do is to look at is how to find a good doctor. This can be trickier than you think and there are a lot of doctors out there that I would not trust to do medical opinions for the veterans that our office represents. First, it is best to vet out a doctor if you find one who you think will be good for your case. Contact the doctor first and ask them questions feel them out and make sure that they are a right fit for you and that you feel they have your best interest in mind. Again this is another reason why having an attorney really pays. If you do go it alone you’ll be vetting doctors on your own hoping that you pick the right one. If you hire an attorney that attorney should already have connection with doctors they can trust whom they can ask for a nexus in your case.

Now in closing I would like to remind you all that there are a lot of scams out there for veterans and disability benefits. A lot of companies charge up front for their services and do not provide actual results. Remember that it is illegal for to do this and that they are only allowed to collect money from
you in the form of past due benefits this means no getting paid unless they win something for you. If the veteran wins from an initial application this also means that the attorney or service does not get to collect a fee. Beware of this and make sure you hire a reputable attorney who knows and understands
the law. Of course obtaining a medical opinion is different because if there is a fee associated with it then it is an upfront cost. However, if you have a good doctor and even better a great attorney they will know how to work your case to maximize your chances at success.

If you have any questions feel free to contact our office at 201-337-7704