ChatGPT Letters

[Brim]

Dude! ChatGPT is awesome.

I was asked by a patient to write a VA Medical Nexus Letter connecting his prostate cancer diagnosis to his prior military service, for disability determination. This was not for Agent Orange. The Veteran had previously filed a disability claim with the VA, but the claim was denied.

ChatGPT to the rescue!!

It produced a beautifully-written and thorough letter providing strong rationale. I even got a list of references.


Here's a sample w/ information redacted.

Hope this is helpful for someone.

---

Subject: Medical Nexus Statement for [Veteran's Full Name]
VA Claim #: [Insert if known]
DOB: [Insert Veteran’s DOB]
Period of Service: [XXX - XXX]
Military Occupational Specialty: [XXX]

To Whom It May Concern:

I am writing this letter on behalf of my patient, [Veteran’s Full Name], to provide a medical opinion concerning the etiology of his prostate cancer and its relationship to toxic environmental exposures during his military service at XXX Air Force Base.

Military Service and Exposure History​

From [xxx] through [xxx], the Veteran was stationed at NoName AFB where he served as a XXX Specialist. His duties included:

• Soil and water testing for contamination
• Handling potentially contaminated materials
• Routine exposure to aircraft exhaust and jet fuel fumes, given the proximity of his role to active Air Force aircraft operations

XXX AFB was officially closed and has since been designated as a Superfund cleanup site by the Environmental Protection Agency (EPA). Notably, the EPA has documented contamination of this site with:

• PFAS (per- and polyfluoroalkyl substances) from firefighting foam and other industrial sources
• Trichloroethylene (TCE), a chlorinated solvent known to leach into groundwater
• Additional hazardous waste compounds, including hydrocarbons and solvents associated with aircraft maintenance

Medical Condition​

[Veteran’s Full Name] was diagnosed with prostate cancer and underwent radiation therapy as part of his treatment. He submitted a VA disability claim for service-connected prostate cancer in xxx. While the VA acknowledged his toxic exposures, the claim was denied, citing insufficient evidence of direct causation.

Medical Nexus Opinion​

It is my professional medical opinion that it is at least as likely as not (50% or greater probability) that the Veteran’s diagnosis of prostate cancer is related to his occupational exposures to environmental toxins during his active military service.

This opinion is based on the following rationale:

1. Documented presence of carcinogens at XX AFB:
   • The EPA’s classification of XX AFB as a Superfund site underscores the significant and prolonged contamination of the environment with PFAS, TCE, and related industrial compounds.
2. Exposure routes consistent with job duties:
   • The Veteran’s daily duties involved soil and water testing, indicating direct contact with contaminated environmental media.
   • Regular exposure to jet fuel and aircraft exhaust fumes further added risk, with known components such as benzene, toluene, and PAHs—several of which are classified as carcinogenic by IARC.
3. Scientific plausibility and precedent:
   • PFAS exposure has been increasingly linked to hormone-related cancers, including prostate cancer, in military and occupational studies.
   • TCE is a Group 1 human carcinogen per IARC. While strongly associated with kidney and liver cancers, there is suggestive evidence implicating prostate cancer as well, especially with chronic low-level exposure.
   • Military and occupational cohorts (e.g., firefighters, aviation workers, water plant operators) show elevated prostate cancer incidence compared to the general population.
4. No significant non-service-related risk factors identified in this patient’s history to account for prostate cancer diagnosis at this age and clinical profile.
   

Conclusion​

In conclusion, there is a credible, medically and environmentally grounded link between [Veteran’s Name]’s exposures at XX AFB and his subsequent diagnosis of prostate cancer. It is my opinion that his condition should be considered service-connected.

Please feel free to contact me for any further clarification.

Respectfully,

[Your Name], [MD]
[Specialty]
[Signature]

---

Members don't see this ad.

 

[ABCXRT]

chatGPT reply from VA:

Subject: Re: Medical Nexus Statement for [Veteran's Full Name]


Dear Dr. [Your Name],


First and foremost, we extend our profound gratitude for your dedicated care and compassion toward our honored veterans. Your thoughtful and thorough nexus letter concerning [Veteran's Full Name] is truly appreciated. It is always heartening to see medical professionals take the time to advocate on behalf of those who served. (Really, thank you so much. Very inspiring.)


After extensively reviewing your submission — and by "extensively," we of course mean printing it out and placing it atop a very noble stack of equally heartfelt paperwork — we must humbly inform you that further procedural steps are required before any substantive consideration can be undertaken.


To that end, we kindly request that the following be completed:

1. VA Form 21-4138 – Statement in Support of Claim
   (Even if the Veteran has already submitted this. Twice.)
2. VA Form 21-0960J-3 – Prostate Cancer Disability Benefits Questionnaire (DBQ)
   Must be hand-signed in ink. Preferably blue ink. By a VA-recognized urologist who also happens to be fluent in Esperanto, just in case.
3. Environmental Exposure Worksheet (Annex G-17a)
   Found in Appendix 32 of the 2003 VA Procedural Reference Compendium (Volume II). Please notarize each page. Yes, including the instructions.
4. Duplicate Copy of All the Above in Triplicate
   We recommend printing on parchment. With official seals, if possible.
5. Optional but Strongly Encouraged:
   A sworn affidavit from a retired Air Force meteorologist confirming prevailing wind directions at NoName AFB between 0600–1800 daily during the Veteran’s service window, to establish exposure plume trajectory consistency.

While we genuinely empathize with the Veteran’s situation and deeply appreciate the compelling nature of your letter, we unfortunately cannot move forward until the aforementioned documentation is received, reviewed, misplaced, rediscovered, re-reviewed, and then forwarded to another department that will, in turn, request the same documents again.


In the meantime, thank you once again for your commitment to our veterans. Your support is vital—and so is paperwork.


Warmest regards (eventually),


Claude D. Farnsworth, III
Supervisory Claims Correspondence Technician
Department of Veteran Affairs, Bureau of External Form Processing (Division 7G-Beta)
"Delay With Dignity Since 1946"
☕ Estimated Response Time: 90–120 business days (weather permitting)