Below is a basic outline of how a Nexus Letter or Independent Medical Opinion is structured. This is not the exact format produced by Valor 4 Vet. This is for basic understanding of how a Nexus Letter is formatted.
At Valor 4 Vet we have developed a quality standard for every Nexus Letter produced by our Medical Experts. The standards have been established to optimize success at the VA Regional Office and meet the legal standards and expectations at the Board of Veterans Appeals.
A Nexus Letter written by Valor 4 Vet will follow the veteran through the claim. This means that if our Medical Expert has written a Nexus Letter and for some reason the veteran is denied due to a lack of medical merit, we will modify the Nexus Letter to re-emphasize the medical link and relationship to service for a small fee.
John Smith, M.D.
PO Box 594
Waverly, OH 45690
May 12, 2015
Re: GI Joe II and his bilateral knee conditions.
To whom it may concern,
My name is Dr. John Smith and I am reaching out in regards to GI Joe II and his bilateral knee conditions. I am familiar with this veteran’s knee conditions and have reviewed his service treatment records and private medical records.
While the veteran was on active duty he was seen on multiple occasions by medical providers and diagnosed with patellofemoral pain syndrome of both knees.
Following military service the veteran’s statement reports that he continued to have pain in both knees.
In 2013 MRIs of the knees showed wear and tear of the cartilage behind the knee cap and was diagnosed with Grade III chondromalacia patella.
It is my expert medical opinion that the veteran’s patellofemoral pain syndrome and chondromalacia patella of both knees is directly related to military service.
The veteran was diagnosed with patellofemoral pain syndrome of both knees in service. The MRI from 2013 demonstrates a progression of the diagnosed knee conditions in service. The progression supports a chronic ongoing condition of the patellofemoral pain syndrome from service.
To further support the rationale, medical literature reports that development of chondromalacia patella is the result of chronic patellofemoral pain syndrome due to anatomical stressors upon the knee.1
The veteran demonstrated an injury in service.
The veteran has a current diagnosed disability.
A medical nexus has been established.
Please reach out if you have any questions regarding this case.
Dr. John Smith, M.D. /es/