A nexus letter is a medical opinion linking a current condition to military service, usually stating that it is "at least as likely as not" (a 50 percent or greater probability) that the condition is related to service. You can ask any treating provider, including one at a military treatment facility (MTF), to write one, but MTF doctors vary widely in how comfortable they are drafting nexus language, since it is a legal/medical opinion rather than routine treatment documentation. Some will decline, some will write a brief statement, and some may be willing to complete a Disability Benefits Questionnaire (DBQ) instead, which VA raters are familiar with and often weigh similarly to a formal nexus letter.
On the privacy question: MHS Genesis is the Department of Defense's electronic health record system, but DoD and VA share medical records through interoperability tools such as the Joint Legacy Viewer (JLV), and VA raters and C&P examiners routinely pull records from both systems when developing a claim. Portal messages sent to a provider are typically stored as part of the encounter or communication record, so it is reasonable to assume that anything written in MHS Genesis, including secure messages, could become part of the record VA reviews, especially if the claim goes to appeal and a decision review officer or Board of Veterans' Appeals judge orders a fuller record. There is no reliable way to send a private, off-the-record message to a treating physician through a government EHR portal.
Official 2026 VA monthly compensation, including the 2.8% COLA increase.
Dependent add-ons start at a 30% rating. Child-only and dependent-parent rates: see the full 2026 pay chart.
| Rating | Monthly (2026, incl. 2.8% COLA) |
|---|---|
| 10% | $180.42 |
| 20% | $356.66 |
| 30% | $552.47 |
| 40% | $795.84 |
| 50% | $1,132.90 |
| 60% | $1,435.02 |
| 70% | $1,808.45 |
| 80% | $2,102.15 |
| 90% | $2,362.30 |
| 100% | $3,938.58 |
Does your rating decision hold up under a real audit?
Upload your decision letter and C&P exams — VetAid's analyzer reads the full file, checks every examiner statement word-for-word against your records, and shows which arguments for a higher rating actually hold. Free, and we never take a cut of your back pay.
Analyze my claim free →If the goal is a clean, defensible nexus opinion, many veterans instead use a private physician or an independent medical opinion (IMO) provider who is experienced writing VA-specific nexus language, since that avoids ambiguity about what is stored where and lets the veteran control exactly what is submitted with the claim (often via VA Form 21-4138 or attached to a new or supplemental claim on VA Form 20-0995). VA is also obligated under 38 CFR 3.159 to assist in obtaining relevant evidence, including scheduling a compensation and pension exam, so a formal C&P exam remains an option if a private nexus is not obtainable.
The concrete next step is to ask the MTF doctor directly, in person or by phone rather than through the portal, whether they are willing to provide a signed nexus statement or complete a DBQ, and if they decline, pursue a private nexus letter or request a VA C&P exam through the claim itself.
Need a deeper analysis?
Our AI checks your situation against outcome data from 1,300,000+ Board of Veterans' Appeals (BVA) decisions (2009–2025).
Analyze Your Claim Free