The short answer
You can, but think about your role first. Providing treatment records or a factual summary of diagnosis, symptoms, and treatment is usually fine. Writing a medical opinion that a condition is linked to service is a forensic task that can strain the therapeutic relationship, so many therapists decline it and point the client to other options.
Can a treating therapist write a letter for a VA claim?
Yes. Nothing stops you, and VA accepts evidence from private providers. The real question is what kind of letter, and whether writing it fits your role.
VA says a disability claim needs evidence of a current condition, an event or injury in service, and a link between them. That link usually comes from medical records or medical opinions. See VA's evidence page.
What's the difference between a treatment summary and a nexus opinion?
| Treatment summary | Nexus (medical) opinion | |
|---|---|---|
| What it says | Diagnosis, symptoms, functional effects, and treatment, from your records | Whether a condition is "at least as likely as not" caused by service |
| What it requires | Your own clinical observations | A review of service and medical records, and a forensic judgment |
| Role | Treating clinician | Evaluator |
| Risk to therapy | Low | Can be significant |
A treatment summary sticks to what you know. A nexus opinion asks you to judge causation, often about events you didn't witness, in a process where your client has a financial stake in the answer.
Why do many therapists avoid nexus opinions?
- Dual roles. Professional ethics codes caution against mixing treatment and forensic roles. Your client needs you as their therapist, not their evaluator.
- The relationship. If the claim is denied, or your opinion doesn't say what the client hoped, therapy can suffer.
- Scope. A causation opinion may require records review and expertise outside your training.
None of that means a treating therapist can never write one. It means think it through, check your licensing board's and professional association's guidance, and decide deliberately.
What can you offer instead?
- Records. Clients can request their records and submit them, or VA can request them with the client's authorization.
- A factual summary of diagnosis, symptoms, treatment, and how the condition affects daily life and work.
- A referral to an accredited Veterans Service Officer (VSO), who can help with the claim at no cost, or to an independent evaluator for a nexus opinion.
- The VA exam. VA usually schedules its own compensation and pension (C&P) exam.
How ValorWell handles this
Whether to write a letter, and what kind, is your clinical and ethical decision. ValorWell doesn't require therapists to write disability opinions. Clients can request their records through the normal records process.
Important limits
- This isn't legal advice. VA's evidence rules are detailed, and accredited VSOs, agents, and attorneys handle claims.
- Never overstate. Write only what your records support.
- Get a signed release before sending anything to VA or a representative.
- VA decides the claim. Your letter is evidence, not a decision.