How to Get Your Records for a VA Claim or Nexus Letter
A nexus letter is only as strong as the records behind it. This guide explains which records matter and where to get each one. You can get many of them yourself, online.
The short version
- A nexus letter rests on three things: a diagnosis from a clinician, a record of what happened in service, and the medical link. The letter itself gives the link.
- You can download your VA medical records, decision letters, and ratings from VA.gov yourself.
- Copies of your DD-214 are free for most veterans.
- You can request a letter before you have every record. A provider can only sign for a condition a clinician has already diagnosed in your records.
What a Nexus Letter Needs
For most claims, a VA rater looks for three things. Your records give the first two. The nexus letter gives the third.
A current diagnosis from a clinician
The diagnosis has to be written in your records by a doctor, nurse practitioner, physician assistant, psychologist, or VA examiner. It does not have to be from your time in service. A diagnosis made years later counts.
These count
- A visit note from your doctor or a VA clinic that names the condition
- A VA exam report (a DBQ) that names it
- A problem list in your medical records that names it
These are not a diagnosis
- A list of symptoms
- A screening score or questionnaire
- Your own statement about the condition
What happened in service
Records that show the injury, event, or exposure during your service:
- Your DD-214. It shows when you served and your job in service.
- A record of the injury or event, such as a sick call slip, an accident report, or your service treatment records.
- A Line of Duty (LOD) determination, if you were in the Reserve or National Guard. Our Reserve and Guard guide explains it.
- A statement from someone who saw it happen. See how to ask for a buddy statement.
Caused or made worse by a condition you are already rated for? Then the record you need is the VA decision letter that rates that condition.
The medical link
This is the nexus letter itself. A clinician reads your records and gives an opinion on whether your condition is at least as likely as not connected to your service, or to a condition you are already rated for. You do not need to find this part. You need to give the clinician the records for the first two.
Nexus letters explained
Records for Common Conditions
Some conditions are rated on one test or record. If yours is below, look for that record first.
Sleep apnea
A sleep study showing your AHI
Polysomnography or an approved home sleep test with a formal diagnosis. A snoring history on its own will not carry this claim.
Your CPAP prescriptionAlso helps
Prescribed CPAP use is what supports the 50 percent level. Without it the rating usually tops out lower.
Migraines and headaches
Treatment records naming your migraine medication
A rater looks for prescribed abortive or preventive medication. Records that only mention headaches read as untreated.
PTSD, depression, anxiety, and other mental health conditions
A mental health diagnosis from a clinician
A note or intake assessment from a psychiatrist, psychologist, or licensed therapist that names the diagnosis. A screening score on its own is not a diagnosis.
GERD and acid reflux
Records showing treatment for reflux
A prescription, an endoscopy, or a GI note. Self-reported heartburn alone rarely establishes severity.
High blood pressure (hypertension)
Blood pressure readings from your records
Hypertension is rated off recorded diastolic and systolic numbers, so the readings themselves are the evidence.
Hearing loss
An audiogram with puretone thresholds
Hearing loss is rated from puretone averages and Maryland CNC speech discrimination scores.
Irritable bowel syndrome (IBS)
A GI evaluation or treatment record
A gastroenterology note, colonoscopy, or prescribed treatment showing the condition was worked up.
Erectile dysfunction
A treatment record or prescription
A urology note or prescribed medication documents the condition rather than leaving it self-reported.
Back, neck, and spine conditions
Imaging or a range-of-motion exam
Spine conditions are rated on measured range of motion, so an X-ray, MRI, or documented ROM exam does the work.
Not listed? The records that count are the three things above: a diagnosis a clinician wrote down, your treatment notes and test results, and a record of what happened in service. The Condition Library shows how the VA rates each condition.
Where to Get Each Record
To use the VA.gov links below, sign in with your ID.me, Login.gov, or CLEAR account. Each VA.gov link opens in a new tab, so this page stays open.
Your VA medical records
If you get care at a VA clinic or hospital, you can find, print, and download your records on VA.gov. That includes visit notes, lab and test results, and care summaries. Download them and upload the file. A Blue Button report you already saved works too.
Open your VA medical records (opens VA.gov in a new tab)Not online, or need older paper records? Your VA facility's Release of Information office can send a complete copy. It can take up to 30 days, or up to 60 days for older paper records. How to ask your VA facility (opens VA.gov in a new tab)
Your DD-214 and service records
You can ask the National Archives for your DD-214 and other records from your service, including your medical records from service. For most veterans, copies are free.
You get a DD-214 each time you leave a period of active duty. If you served more than once, you may have more than one. Ask for all of them.
Request your service records (opens VA.gov in a new tab)If you already applied for VA benefits, the VA asks for your DD-214 itself. To upload it here, you need your own copy.
Your VA claim and decision letters
Your decision letters show what the VA decided and why. For a condition caused or made worse by one you are already rated for, the decision letter that rates that condition is the record to upload.
Open your VA claim letters (opens VA.gov in a new tab)Your VA disability ratings
This page lists each condition you are rated for and its percentage, and shows which ones are service connected. It is a quick way to check the exact name of a rated condition.
See your VA disability ratings (opens VA.gov in a new tab)Your C&P exam results
If the VA already examined you, the examiner's report (a DBQ) may name your diagnosis. Our guide explains how to ask for a copy.
How to get your C&P exam resultsRecords from a private doctor
Call the office or use its patient portal. Ask for your visit notes and any test results. Notes that name the diagnosis matter most.
A clear photo of a paper record works. Lay the page flat in good light, fit the whole page in the picture, and take one photo for each page.
You Don't Need Every Record to Start
You can request a nexus letter before you have every record. We read every record on your account, not only the ones you add to the request.
One rule we can't skip
A provider can only sign a letter for a condition a clinician has already diagnosed in your records. If no record names your diagnosis yet, start there: see your VA or private doctor, then upload the visit note.
Upload Your Records and Request Your Letter
Upload what you have now, then request your letter. You can add more records at any time.
A licensed provider reviews your records and signs only if the evidence supports their opinion. The VA decides every claim.
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.