Why does VA reject private medical opinions?

VA nexus letters from private treating doctors or VA treating doctors are usually insufficient to bring a favorable outcome. These doctors are looking to avoid litigation and bias their medical opinions toward that goal – not toward supporting your VA claim. They don’t want to flat out state that a veteran’s service was 50% likely to have caused her disability – because they can’t know that for certain. So they use vague, speculative language that ultimately dumbs down your claim.

For instance, a VA nexus letter from a private treating doctor might say something like, “It is possible that the veteran’s breast cancer resulted from toxic water exposure at Camp Lejeune,” when an experienced nexus letter doctor knows the VA requires definite language, such as “After a thorough review of the evidence, it is my professional opinion that the veteran’s service at Camp Lejeune is as likely as not to have caused his breast cancer diagnosis.”

Importantly, private physicians don’t understand the VA standard of proof. They’re trained to avoid saying a disease is caused by some event unless they know with absolute certainty, like if someone started having seizures after a traumatic brain injury (and even then they wouldn’t say they are certain there is a connection). If they can’t say it with absolute certainty, they won’t say it at all.

Most private doctors don’t have the data available to them or lack the time required to sift through it and form a cogent, informed opinion. Experienced nexus letter doctors have already established vast resources, know what language the VA expects to see, and are confident in supporting a link between service and disability using the “at least as likely as not” (>50%) standard of proof the VA requires.