Claim Situation
What makes a medical opinion hold up, and the red flags that sink one
· Claim Situation
The situation
A nexus opinion is a clinician's written opinion that your condition is related to service or to a service-connected condition. It is often the piece that decides the claim.
What a strong opinion includes
- States the clinician reviewed your records and history.
- Uses VA's standard: "at least as likely as not" (50% or greater).
- Explains the medical reasoning step by step.
- Addresses negative evidence, such as other risk factors.
- Cites medical literature when relevant.
Seven red flags raters discount
- No mention of records review.
- Speculative words: "may," "could," "possibly."
- A conclusion with no reasoning.
- Uses the wrong standard, such as "possible" or "cannot rule out."
- Ignores contrary evidence.
- Template language that isn't about you.
- Outside the clinician's expertise.
Where to get one
- Your treating VA or private provider.
- Ask for it in writing; give them a short summary of your history.
- You don't have to pay anyone to file a claim; free VSOs can help organize the request.
Answer a negative exam
If a C&P opinion is negative, a strong private opinion can balance the evidence (38 CFR 3.102).
Related
Get free help
You never have to pay to file an initial VA claim. Free help: a VSO such as DAV, VFW or the American Legion, or a VA-accredited representative.
Educational only, not legal or medical advice. We are not VA-accredited. No one can promise an outcome; VA decides each claim on its own evidence. Rules and rates change; check the linked VA and eCFR sources.