PTSD Nexus Letters for Veterans
Harvard-Trained Psychiatrist | Board-Certified MD | 5-Day Turnaround | $600
What is PTSD in Veterans?
Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition that develops after exposure to traumatic events during military service. For veterans, PTSD is one of the most common service-connected mental health conditions, affecting approximately 11-20% of veterans who served in Operations Iraqi Freedom and Enduring Freedom, according to VA research.
PTSD manifests through four primary symptom clusters defined by the DSM-5:
- Intrusive Memories: Recurring, involuntary memories of the traumatic event, nightmares, and flashbacks
- Avoidance: Deliberate efforts to avoid trauma-related thoughts, feelings, people, places, or activities
- Negative Alterations in Cognition and Mood: Persistent negative beliefs, distorted blame, diminished interest in activities, and feelings of detachment
- Alterations in Arousal and Reactivity: Hypervigilance, exaggerated startle response, irritability, reckless behavior, and sleep disturbances
Common traumatic exposures for veterans include combat operations, improvised explosive device (IED) blasts, witnessing casualties, military sexual trauma (MST), and operational stress from repeated deployments.
Did you know?
The VA recognizes PTSD as one of the most common service-connected disabilities, with over 1.3 million veterans currently receiving disability compensation for PTSD.
VA Service Connection Criteria for PTSD
To establish service connection for PTSD, the VA requires three key elements:
1. Current documented condition of PTSD
A formal condition documented in medical records
from a qualified mental health professional (psychiatrist, psychologist, or licensed clinical social worker) based on DSM-5 criteria. The documented condition
must be supported by clinical evidence including symptom Independent Medical Opinion, psychiatric history, and functional impairment record review.
2. In-Service Event, Injury, or Illness
Evidence of a traumatic stressor that occurred during active military service. For combat veterans, this can be established through service records, deployment history, combat action ribbons, or lay statements. The VA has relaxed evidentiary standards for combat-related PTSD.
3. Medical Nexus (Causal Link)
A medical opinion establishing that your current PTSD is “at least as likely as not” (50% or greater probability) caused by or aggravated by your military service. This is where a nexus letter becomes critical.
Primary vs. Secondary Service Connection for PTSD:
Primary Service Connection: Your PTSD is directly caused by a traumatic event during military service (e.g., combat exposure, MST, training accidents).
Secondary Service Connection: Your PTSD developed as a consequence of another service-connected condition. For example:
- PTSD secondary to traumatic brain injury (TBI)
- PTSD secondary to chronic pain (witnessing traumatic medical events)
- PTSD aggravated by service-connected physical disabilities
Important: “At Least As Likely As Not” Standard
The VA uses a 50% probability standard. Your nexus letter must state that it is “at least as likely as not” (≥50%) that your PTSD is related to your military service. This is a lower burden of proof than “more likely than not” (>50%).
How a PTSD Nexus Letter Strengthens Your Claim
A PTSD nexus letter is a critical piece of medical evidence that bridges the gap between your current documented condition and your military service. Here’s why it matters:
Establishes Medical Causation
VA C&P examiners often lack the time or expertise to thoroughly review complex psychiatric histories. A comprehensive nexus letter from a board-certified psychiatrist provides the medical reasoning the VA needs to approve your claim.
Counters Unfavorable C&P Exams
If you receive a negative Compensation & Pension (C&P) exam, an independent nexus letter provides a competing medical opinion that the VA must consider. This is especially powerful when from a psychiatrist with superior credentials.
Supports Appeals
For denied claims, a detailed nexus letter can be the difference between continued denial and approval. The Board of Veterans’ Appeals (BVA) frequently remands cases when strong medical evidence is introduced.
References Medical Literature
A strong nexus letter cites peer-reviewed research, epidemiological studies, and clinical practice guidelines that support the connection between your military experiences and your PTSD symptoms.
What Makes a Strong PTSD Nexus Letter?
An effective PTSD nexus letter includes:
- Comprehensive review of service records documenting traumatic stressors, deployment history, and operational experiences
- Detailed analysis of VA medical records including C&P exam reports, medical records, and hospitalization records
- Psychiatric Independent Medical Opinion confirming current DSM-5 PTSD condition documented in medical records with symptom inventory
- Medical literature citations supporting the causal relationship between combat exposure/trauma and PTSD
- Clear nexus statement using VA-required language (“at least as likely as not”)
- Analysis of alternative explanations and why service connection is the most probable cause
- Functional impairment record review documenting how PTSD affects daily life, work, and relationships
Why Choose VetNexusMD for Your PTSD Nexus Letter
Dr. Ronald Lee, MD – Harvard-Trained Psychiatrist
✓ Harvard Medical School Graduate
✓ Board-Certified Psychiatrist
✓ VA System Experience
Board-Certified by the American Board of Psychiatry & Neurology (ABPN)
✓ Trauma-Focused Expertise
✓ Evidence-Based Approach
Dr. Lee specializes in PTSD and trauma-related disorders, with deep understanding of the unique mental health challenges faced by veterans. His nexus letters combine psychiatric expertise with knowledge of VA regulations and evidentiary standards.
Our PTSD Nexus Letter Process
Free Consultation
Discuss your PTSD claim and military history. We’ll explain the nexus letter process and answer questions.
Records Submission
Provide military service records, VA medical records, C&P exam reports, and any private treatment records.
Psychiatric Review
Dr. Lee conducts comprehensive records review and psychiatric Independent Medical Opinion (telehealth available for most states).
Nexus Letter Delivery
Receive your comprehensive PTSD nexus letter within 5 business days of payment and receipt of all required documents.
Pricing: $600 Flat Fee
No hidden costs. No hourly billing. One comprehensive PTSD nexus letter for $600.
Turnaround Time: Within 5 business days of payment and receipt of required documents
Delivery: Digital PDF via secure email, ready to submit to VA
Frequently Asked Questions
How much does a PTSD nexus letter cost?
Our PTSD nexus letters are $600 flat fee. This includes comprehensive records review, psychiatric Independent Medical Opinion, medical literature research, and a detailed nexus opinion letter. No additional charges.
How long does it take to get my PTSD nexus letter?
Within 5 business days of payment and receipt of all required documents. If you need expedited service, please inquire during your consultation.
What records do I need to provide?
For a PTSD nexus letter, we need:
- DD-214 (military discharge papers)
- Service treatment records (STRs) documenting in-service events
- VA medical records including C&P exam reports
- Private treatment records (if applicable)
- Deployment records, unit history, or other documentation of traumatic stressors
- Personal statement describing your PTSD symptoms and military experiences
Will a nexus letter guarantee my PTSD claim is approved?
No. A nexus letter is strong medical evidence, but the VA makes the final decision based on all evidence in your claim file. However, a well-written nexus letter from a board-certified psychiatrist significantly improves your chances of approval, especially when VA examiners provided unfavorable opinions or when the medical causation is complex.
What’s included in your PTSD nexus letter?
Our comprehensive PTSD nexus letters include:
- Dr. Lee’s credentials and qualifications
- Summary of records reviewed (service records, VA records, private records)
- Clinical history and psychiatric Independent Medical Opinion findings
- DSM-5 PTSD condition documented in medical records (with symptom analysis)
- Discussion of in-service traumatic stressors
- Medical literature citations supporting the nexus
- Clear nexus opinion statement using VA-required language
- Analysis of functional impairment
- Response to alternative explanations (if applicable)
Typical length: 8-15 pages depending on case complexity.
Do I need to see Dr. Lee in person?
Most evaluations can be conducted via telehealth (video consultation). In-person evaluations are available at our Boston, MA office if needed. Dr. Lee is board-certified by the American Board of Psychiatry & Neurology (ABPN)
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