You have a strong nexus letter. Now it has to reach the VA correctly and at the right time. Submitting evidence the wrong way can slow a claim or cause it to be overlooked. This guide covers the how and the when.
When to submit it
A nexus letter can be submitted at various points:
- With an initial claim (VA Form 21-526EZ)
- With a Supplemental Claim after a denial (VA Form 20-0995)
- During an appeal
Submitting it alongside your claim or appeal, rather than after a decision, is generally recommended so the reviewer has it in hand.
How to submit it
You have a few options:
- Online through VA.gov when filing or supplementing your claim
- By mail to the VA Evidence Intake Center
- In person at a VA regional office
- Through an accredited representative (a VSO or VA-accredited attorney or agent), which helps ensure it is submitted correctly
Labeling it correctly
When you submit a private medical opinion as evidence, it should be clearly identified as such so the VA files it correctly. Some providers advise marking it as a private medical opinion on the applicable evidence form (historically VA Form 20-10208).
Keep copies
Always keep a copy of the letter and proof of submission. If a question arises later, your records matter.
Working with a representative
An accredited representative can handle submission for you and confirm it lands correctly. Many veterans find this reduces errors, especially on appeals.
A real-world example
A veteran had a strong nexus letter but mailed it separately, weeks after his claim, without clearly labeling it. It was slow to make it into his file. On his next submission, he included it with the claim and labeled it as a private medical opinion, and it was considered from the start.