Nexus letter
Major depressive disorder
Direct service connection, or depression secondary to a painful or limiting service-connected condition.
$895 for this condition · $149 to start
What this claim turns on
Depression reaches the VA two ways. It can be directly connected to service, or it can be secondary — the predictable consequence of living with chronic pain, lost function, or another service-connected condition. The secondary route is where most claims are won and lost, because it requires a physician to explain the mechanism: how persistent pain disrupts sleep, how disrupted sleep degrades mood regulation, and how that progression produces a depressive disorder. That is a medical argument, and it needs a medical author. Our physicians document the chronology and state the causal reasoning in the terms an adjudicator is trained to weigh.
Commonly claimed as secondary to
If one of these is already service connected, this condition may be claimable as secondary to it. Your intake asks which pathway applies.
Conditions often secondary to this one
If depression is already service connected for you, these conditions are frequently claimed as flowing from it. Each needs its own opinion.
Records to have ready
Your physician needs these to form an opinion. Gathering them before you start is the single biggest thing you can do to move your case quickly.
- DD-214 or other separation document
- Service treatment records covering your time in service
- Current VA or private treatment records showing a diagnosis
- Any VA rating decision or denial letter you have received
- Mental health treatment records and medication history
- Records for the service-connected condition you believe caused it, if claiming secondary
Missing something? Start anyway and tell us in the intake. Sometimes a gap changes the approach rather than stopping the claim. How to request your records.