Depression Nexus Letters for VA Claims

Veteran-Specific Presentations

Veterans with depression may also experience irritability, anger outbursts, substance use, chronic pain, and somatic complaints. These presentations are often linked to combat stress, moral injury, survivor’s guilt, and adjustment difficulties.

Primary Service Connection

Your depression is directly caused by an event, injury, or exposure during active military service. Examples include:

• Depression following combat trauma or operational stress
• Depression resulting from military sexual trauma (MST)
• Depression caused by in-service traumatic brain injury (TBI)
• Depression from adjustment difficulties related to deployment
• Depression secondary to service-connected physical injuries

Secondary Service Connection

Your depression developed as a consequence of another service-connected condition. This is one of the most common pathways for depression claims. Examples include:

• Depression secondary to PTSD: Depression frequently co-occurs with PTSD, with shared neurobiological mechanisms and symptom overlap
• Depression secondary to chronic pain: Persistent pain conditions (back injuries, knee injuries, neuropathy) are strongly associated with depression through both biological and psychosocial mechanisms
• Depression secondary to TBI: Traumatic brain injury increases depression risk due to structural brain changes and functional impairments
• Depression secondary to tinnitus: Chronic tinnitus can cause sleep disturbance, concentration difficulties, and emotional distress leading to depression
• Depression aggravated by service-connected disabilities: Even if depression existed before service, it can be aggravated (worsened) by service-connected conditions

Pro Tip: Secondary Claims Are Often Easier to Win

If you already have a service-connected condition (like PTSD, chronic pain, or TBI) and have developed depression, a secondary claim may be strategically advantageous. The in-service event requirement is already established—you only need to prove the medical connection between your existing condition and depression.

Dr. Ronald Lee – Specialized Psychiatric Expertise

How much does a depression nexus letter cost?

$600 flat fee. No hidden costs, no hourly billing. Includes records review, evaluation, and comprehensive nexus letter.

What’s the turnaround time?

Within 5 business days of payment and receipt of all required documents.

Can I get a nexus letter for depression secondary to another condition?

Yes. This is one of our most common request types. We frequently write nexus letters for:

• Depression secondary to PTSD
• Depression secondary to chronic pain (back, knees, joints)
• Depression secondary to TBI
• Depression secondary to tinnitus or other service-connected conditions

You’ll need to provide documentation of your existing service-connected condition (VA rating decision letter) along with medical records.

Will this guarantee my depression claim is approved?

No. The VA makes the final decision. However, a well-supported nexus letter from a board-certified psychiatrist with Harvard credentials significantly strengthens your claim and provides compelling medical evidence the VA must consider.

What if I don’t have a formal depression diagnosis yet?

Dr. Lee can diagnose Major Depressive Disorder as part of the evaluation if you meet DSM-5 criteria. The nexus letter will include both the diagnosis and the nexus opinion linking it to your service.

Do you offer comprehensive medical record reviews?

Yes. Most depression evaluations can be conducted via secure video consultation. Dr. Lee is Board-Certified by American Board of Psychiatry & Neurology (ABPN).