Why Nexus Letters: Bridging the Gap for Veterans’ Disability Benefits

Why Nexus Letters.

I had a veteran client who was having trouble getting his sleep apnea service-connected. He was fortunate that he had private health insurance. He asked his ENT, whom he had been a long-time patient of, and asked if he would write the vet a nexus letter. The doctor wouldn’t even consider it. The doctor also happened to be a veteran himself. The vet went to his sleep doctor, the one he sees for his sleep condition, and asked him if he would write a nexus letter. The sleep doctor said it was the vet’s primary care physician’s responsibility and declined.

Finally, some good news! His primary care physician said yes, she would write him a nexus letter. Days went by. Days turned into weeks. No nexus letter appeared. When my vet buddy asked his doctor’s office about the status of the letter, they acted as if he was asking them to explain the time/space continuum. His doctor messaged him back after almost 2 months of waiting telling him that she could not write the nexus letter, as it turns out, as it was against the policy of the medical group she practiced under. A corporate blockade.

“Well, what about the VA?” you ask. He had already “been there, done that”.

Revoluble started as a way to enable US military veterans to obtain a nexus letter from accredited medical providers. The struggle that many veterans face is their VA doctors do not want to write nexus letters. The VA doctors claim a “conflict of interest” or that it is illegal or against the rules for them to do so.

This is blatantly false. While this might have been correct pre-Covid the Veterans Health Administration (VHA) has issued a provision which clearly states “This directive establishes policy requiring VHA health care providers, when requested and consistent with other VHA policies, to assist patients in completing Department of Veterans Affairs (VA) and non-VA medical forms and to provide patients with medical statements with respect to their medical condition(s) and functionality.“ – VHA Directive 1134(2) (amended 11 May 20)

This directive has been in place for over 2 years. While building out Revoluble’s network of medical providers in all 50 States, many accredited medical providers, who happen to work for the VA, regretfully declined to participate in this noble endeavor. The reason they cited “conflict of interest”.

Imagine the frustration the veteran feels. Many feel like getting a nexus letter is a Catch-22. Let me break this down for my civilian friends: it’s akin to trying to get your first real job: you can’t get a job because you don’t have experience. You can’t get experience without a job. Many of you remember the frustration you felt during this time in your life.

For a veteran, suffering from either a physical or mental condition, they need and deserve to have that condition service-connected. Meaning, their military service either caused or made worse the condition the veteran is suffering from. Often, a VA doctor is treating the vet for the condition. The VA doctor diagnosed the vet with the condition(s). The VA doctor prescribed medication, but won’t write a nexus letter out of a perceived conflict of interest.

The veteran is left seeking assistance from private medical providers like my client above. Most want nothing to do with the VA and the resulting red tape and bureaucracy as illustrated earlier. Again, for my civilian friends: have you ever “interviewed” a doctor? Say you have a specific health concern and you’ve just moved to a new area. The first thing you do is look up your health insurance provider’s list of qualified service providers. Then you filter out any criteria the health insurance provider’s application would let you screen for. This process can only take you so far. Next, you schedule your appointment.

You get to your appointment. You’ve dropped the kids off at school/daycare. You’ve taken PTO and asked your buddy Bobby to cover for you in today’s department meeting. First, you meet the receptionist. Then you fill out all the paperwork. Then you pass a pharmaceutical rep on his way out as you go to meet the first nurse. Then you meet the doctor. Through this series of events, you start to have a suspicion that you are in the wrong place. Then during your conversation with your doctor, you realize that he wants to take an aggressive approach with abundant prescriptions ahead of a possible surgery. You were fine with the idea of diet and exercise. Losing some weight and possibly taking some herbal supplements.

It’s easy to see the disconnect there. You’ve got 2 choices. Continue seeing this doctor or go through the whole process again to find someone you jive with. This is just to receive primary care! No mention of obtaining some letter the doctor has likely never heard of. This is the run-around that my fellow disabled veterans encounter on a daily basis all over the country.

Many simply give up.

Recent studies estimate over 30% of Iraq and Afghanistan veterans struggle with PTSD, depression, or traumatic brain injury. Yet only around 50% of veterans suffering from these psychological wounds seek VA disability benefits. A key barrier is difficulty obtaining nexus letters to link their current condition to their military service. Without nexus letters, thousands of veterans go undiagnosed and untreated every year. This contributes to alarming statistics – approximately 17 veterans die by suicide every day, and veterans are twice as likely to die by suicide compared to civilians. Homelessness among veterans is significantly higher compared to the overall population as well. Providing an accessible pathway for veterans to get nexus letters could encourage more to seek help and lower these tragic rates.

Nexus letters are the gateway to critical resources for veterans beyond just financial compensation. With a service-connected disability established by a nexus letter, veterans gain access to healthcare, medications, therapy, and support programs tailored to their needs. This improves health outcomes and quality of life. Service-connected disabilities also open doors to job training, housing assistance, assisted living benefits, educational programs, and more. With these resources, veterans are empowered to continue serving their communities and living an independent, dignified life. Too many veterans are denied this opportunity when nexus letters remain out of reach. Streamlining this process serves not just individual veterans but society as a whole.

At Revoluble, we provide a solution to the nexus letter dilemma. Our network of credentialed medical providers stands ready to thoroughly review a veteran’s medical records and write a customized nexus letter linking current conditions to military service. We ease the frustrations facing veterans stuck in the VA backlog. With an accessible roadmap to obtaining nexus letters, veterans can get the care and benefits they deserve in a timely manner. Revoluble serves veterans by unblocking the system, empowering better health and brighter futures.