Most denials are not about whether a veteran is sick or injured. They are about which of the three elements the record failed to establish. Reading your decision letter carefully tells you which one.
The common gaps
- No current diagnosis in the record - symptoms are documented but no clinician named the condition
- No in-service event identified - the injury happened but was never written down
- No medical link - both ends are documented, nothing connects them
- An unfavorable C&P opinion that the record never rebutted
- A secondary pathway that was never claimed or addressed
- A pre-existing condition treated as not aggravated by service
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.
Matching evidence to the gap
A nexus letter closes the third and fourth gaps and is often the only thing that will. It does nothing for a missing diagnosis - that requires a clinical evaluation. For a missing in-service event, lay and buddy statements, unit records, and personnel files carry more weight than a medical opinion - our personal statement guide explains how to write one. A secondary pathway that was never argued is another common gap, and a paid medical records review is the practical way to find out which applies to you, with a nexus letter supplying the opinion when one will help.