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For veterans seeking a migraine VA rating, a medical nexus letter can be a crucial piece of evidence. Veterans include nexus letters in VA migraine claims to help prove that their migraines aren’t just a coincidence but are caused or aggravated by their time in service.
A nexus letter is a document a qualified medical professional provides that links a veteran’s migraines with military service using scientific literature, the veteran’s medical and military history, and medical expert opinion. The VA uses nexus letters to evaluate whether a veteran’s condition is service-connected, a requirement for migraine disability rating, and subsequent benefits. To learn more about VA migraine ratings—including VA criteria, migraine nexus letters, and tactics to prove a secondary-service connection for migraines—read our free eBook, VA Disability Ratings for Migraines: An Essential Guide for U.S. Veterans.
When Do Veterans Need to Include a Migraine Nexus Letter with a VA Claim?
Not all VA migraine claims require a nexus letter. But in cases where the connection between service and migraines isn’t obvious or well-documented, a nexus letter becomes essential.
A migraine nexus letter is particularly important in situations where:
- Service Records Lack Documentation: If service records do not explicitly show evidence that the migraines started during military service or that some specific event during service likely caused them, a nexus letter can provide the necessary link.
- Post-Service Diagnosis: When migraines are diagnosed after service, a nexus letter can help demonstrate that they were caused or aggravated by military duties.
- Discrepancies in Evidence: If there are conflicting medical opinions or insufficient medical evidence in the claim, a nexus letter can help clarify the connection.
What Content Should a Migraine Nexus Letter Include?
A well-crafted nexus letter must contain specific information to be effective and persuasive. Here are some essential elements of migraine nexus letters:
Medical Professional’s Credentials: The letter should include the name, qualifications, and professional credentials of the medical professional writing it. The medical professional should have extensive experience in migraine cases.
Veteran’s Medical History: Migraine nexus letters should outline the veteran’s medical history, including migraine symptoms, diagnosis, and treatment history.
Service History and Exposure: The letter must detail the veteran’s military service, including specific duties, exposures, and any incidents that could be linked to the development of migraines.
Medical Opinion and Rationale: The core of the nexus letter is the medical professional’s opinion on the connection between the veteran’s migraines and their service. This section should include a detailed explanation of how service-related factors are likely causing or aggravating the migraines.
Clear and Concise Language: The letter should avoid ambiguity and clearly establish a primary or secondary link between the veteran’s migraines and their service. The VA is looking for specific language, such as the migraines are “at least as likely as not” caused by military service.
Scientific Evidence Supporting the Claim: Where applicable, the letter should reference relevant medical studies or literature that supports the connection between service and migraines.
Who Can Write a Nexus Letter for Migraine VA Rating Claims?
Migraine nexus letters should be written by a qualified medical professional who has expertise in (1) migraines, (2) the definition of service connection, and (3) an understanding of the VA claim review criteria. Those qualified to write nexus letters for VA migraine claims may include primary care physicians, neurologists, and occupational medicine specialists.
While veterans might be tempted to draft their own nexus letter, it is generally not advisable. Even if a letter written by a veteran is well-informed and detailed, it lacks the authoritative weight and credibility of a letter from a licensed healthcare provider.
How Do Veterans Find Doctors Qualified to Write a Migraine Nexus Letter?
Finding the right doctor to write a nexus letter can be challenging. There are certainly plenty of licensed medical professionals who specialize in migraines, but it is harder to find such professionals who also clearly understand the intricacies of service connection and the claims process.
One of the most effective ways to find a qualified doctor is through a VA disability lawyer. These legal professionals work with a network of medical experts who specialize in writing compelling nexus letters and can help streamline the process. To learn more about migraine VA ratings—including VA criteria, migraine nexus letters, and tactics to prove a secondary-service connection for migraines—read our free eBook, VA Disability Ratings for Migraines: An Essential Guide for U.S. Veterans.