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Nexus Letter Templates

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A nexus letter is the piece of paper that connects your disability to your military service. Without it, the VA can — and will — deny your claim. These templates are starting points. Your doctor writes and signs the final letter.

Available Templates

Sleep Apnea → PTSD Nexus

For veterans claiming sleep apnea secondary to PTSD.

This template establishes the medical nexus between PTSD-related sleep disturbances and the diagnosis of obstructive sleep apnea, citing peer-reviewed literature supporting the connection (38 CFR § 3.310).

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[Date]

Re: Sleep Apnea secondary to PTSD Nexus

To Whom It May Concern:

I am a licensed physician currently treating [Veteran Full Name], DOB [DATE], for [PRIMARY CONDITION — e.g., PTSD]. This letter provides my medical opinion regarding the etiology of [SECONDARY CONDITION — e.g., sleep apnea / hypertension / GERD].

It is my opinion that it is at least as likely as not (50% or greater probability) that [SECONDARY CONDITION] is proximately due to or the result of the veteran's service-connected [PRIMARY CONDITION], based on the following medical rationale:

[PHYSICIAN: Insert 2–4 sentences of medical reasoning here, citing specific peer-reviewed studies, diagnostic findings, and how the primary condition directly causes or aggravates the secondary condition.]

This opinion is based on my review of the veteran's medical records, treatment history, and current clinical presentation.

Sincerely,

[Physician Name, Credentials]

[Practice Name, Address, License Number]

Hypertension → PTSD Nexus

For veterans claiming hypertension secondary to PTSD.

This template connects PTSD-induced chronic stress and sympathetic nervous system activation to the development or worsening of hypertension, supporting secondary service connection under 38 CFR § 3.310.

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[Date]

Re: Hypertension secondary to PTSD Nexus

To Whom It May Concern:

I am a licensed physician currently treating [Veteran Full Name], DOB [DATE], for [PRIMARY CONDITION — e.g., PTSD]. This letter provides my medical opinion regarding the etiology of [SECONDARY CONDITION — e.g., sleep apnea / hypertension / GERD].

It is my opinion that it is at least as likely as not (50% or greater probability) that [SECONDARY CONDITION] is proximately due to or the result of the veteran's service-connected [PRIMARY CONDITION], based on the following medical rationale:

[PHYSICIAN: Insert 2–4 sentences of medical reasoning here, citing specific peer-reviewed studies, diagnostic findings, and how the primary condition directly causes or aggravates the secondary condition.]

This opinion is based on my review of the veteran's medical records, treatment history, and current clinical presentation.

Sincerely,

[Physician Name, Credentials]

[Practice Name, Address, License Number]

GERD → PTSD Nexus

For veterans claiming GERD/acid reflux secondary to PTSD.

This template establishes the nexus between PTSD-related stress, medication use (SSRIs/SNRIs), and the development of gastroesophageal reflux disease (GERD) as a secondary condition under 38 CFR § 3.310.

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[Date]

Re: GERD secondary to PTSD Nexus

To Whom It May Concern:

I am a licensed physician currently treating [Veteran Full Name], DOB [DATE], for [PRIMARY CONDITION — e.g., PTSD]. This letter provides my medical opinion regarding the etiology of [SECONDARY CONDITION — e.g., sleep apnea / hypertension / GERD].

It is my opinion that it is at least as likely as not (50% or greater probability) that [SECONDARY CONDITION] is proximately due to or the result of the veteran's service-connected [PRIMARY CONDITION], based on the following medical rationale:

[PHYSICIAN: Insert 2–4 sentences of medical reasoning here, citing specific peer-reviewed studies, diagnostic findings, and how the primary condition directly causes or aggravates the secondary condition.]

This opinion is based on my review of the veteran's medical records, treatment history, and current clinical presentation.

Sincerely,

[Physician Name, Credentials]

[Practice Name, Address, License Number]

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⚡ Do This Now

→ Print the template. Bring it to your next appointment. Ask your doctor to review and sign on their letterhead.

Key Point

These are educational templates. Your doctor must review, modify, and sign the final letter. SecondaryClaims.com does not provide medical or legal advice.

Want the full nexus letter + claim guide?

The Sleep Apnea Playbook includes a complete nexus letter template, C&P prep, and step-by-step filing. $67.

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Disclaimer: SecondaryClaims.com is an independent veteran-authored educational publisher. We are not accredited by the U.S. Department of Veterans Affairs under 38 CFR § 14.629 and do not provide legal advice.