Veterans often ask whether a nexus letter will raise their rating. The honest answer is that it depends on which question is actually open in your case. Service connection and rating percentage are two separate decisions, and they turn on different evidence.
Service connection versus rating percentage
Service connection asks whether a condition is related to service. Rating percentage asks how severe the condition is, measured against the criteria in 38 CFR Part 4. A medical opinion is the evidence for the first question. Documented severity - test results, frequency of symptoms, functional loss, treatment records - is the evidence for the second. The role of medical evidence breaks down where each piece fits.
Where an opinion can affect your combined rating
The most common path is a secondary condition. If a new condition is medically linked to a disability you are already rated for, it can be evaluated on its own and folded into your combined rating. Secondary service connection explains the standard; the combined rating calculator shows how VA math works, since ratings are combined rather than added.
- Hypertension linked to sleep apnea or to a mental health condition
- Migraines linked to tinnitus, a neck condition, or a head injury
- Foot and knee conditions linked to an altered gait from a service-connected joint
- Depression or anxiety arising from chronic pain
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service or an already service-connected disability.
When an opinion is not the missing piece
If a condition is already service connected and the dispute is only about severity, the useful evidence is usually current clinical documentation measured against the rating criteria, not another statement about causation. Guides such as knee ratings and migraine ratings show what those criteria look for.
What we do and do not do
We produce medical evidence. We do not file claims, provide legal advice, or represent veterans in appeals, and no one can promise a particular outcome - the VA decides. If our reviewing clinician cannot support an opinion for a condition, we say so rather than write something weak. A medical records review is the usual starting point when you are unsure whether the open question in your case is connection or severity, and a VSO can help with the filing itself at no charge.