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For Clinicians · Page 1 of 4

Page 1 of 4

What's Being Asked of You

A veteran has handed you a VA Disability Benefits Questionnaire (DBQ) or asked for a nexus letter. Here's exactly what that request is — and isn't — asking of you.

When a veteran asks you to fill out a DBQ or write a nexus opinion, VA is really asking for three specific things. Only two of them are medical. The third — whatever a veteran may assume — is never yours to decide.

1. Document the Condition

  • What the diagnosis is, based on your exam or the record
  • Current severity and how it affects function
  • Objective findings — test results, imaging, exam notes

2. Explain a Medical Connection

  • Whether the condition is at least as likely as not related to service (see Page 2)
  • Or whether a service-connected condition made another condition worse (see Page 3)
  • The medical reasoning behind that opinion, in your own words

3. NOT Yours: Deciding Entitlement

  • Whether the veteran qualifies for benefits
  • What percentage rating the condition deserves
  • Whether the claim should be approved or denied
Why this matters: A VA rater, not a treating provider, applies the law to the facts and assigns a rating. Your job is to give that rater accurate, well-reasoned medical findings and a clear opinion on the medical question — not to predict or state what the outcome should be. A DBQ or letter that tries to answer the entitlement question directly (e.g., "this veteran deserves a 70% rating") doesn't carry more weight — it just isn't what's being asked, and raters will set that part aside and look for the medical opinion underneath it.

The next three pages walk through the two medical questions in more depth: the probability standard VA uses (Page 2), the difference between causing a condition and aggravating one (Page 3), and how to write an opinion that actually gives the rater what they need (Page 4).

The Veteran Roadmap is an independently operated small business and is not affiliated with, endorsed by, or sponsored by the U.S. Department of Veterans Affairs. Content is for informational purposes only and does not constitute legal, financial, or medical advice.