Question 1

What is a nexus letter?

Accepted Answer

A nexus letter is a written medical opinion from a qualified healthcare provider stating whether a current diagnosed condition is connected to something that happened during military service. It explains the reasoning behind that conclusion and identifies the evidence it relies on. The VA uses it as medical evidence when deciding a disability claim.

Question 2

Do I actually need one?

Accepted Answer

Not always. If your condition is on the VA's presumptive list and you meet the service requirements, service connection may be presumed without a nexus opinion. If your service treatment records already document the condition clearly and continuously, you may not need one either. A nexus letter matters most when there is a gap the VA has to reason across — a condition diagnosed after service, a secondary condition, or a claim that was previously denied for lack of medical evidence. If a letter would not help you, we would rather tell you that than sell you one.

Question 3

What does “at least as likely as not” mean?

Accepted Answer

It is the standard of proof the VA applies. It means a 50 percent or greater probability that the connection exists. It does not mean certainty, and it does not mean more likely than not. If the evidence is evenly balanced, the benefit of the doubt goes to the veteran. A credible nexus letter states the opinion in those terms and explains the medical reasoning that gets it there.

Question 4

Will a nexus letter guarantee my claim is approved?

Accepted Answer

No, and you should be sceptical of anyone who tells you otherwise. The VA weighs all the evidence in your file and reaches its own decision. A well-reasoned medical opinion from a licensed physician is strong evidence, and in many claims it is the missing piece, but it is one piece. We cannot promise a grant, a particular rating percentage, or an effective date.

Question 5

Who writes the letter?

Accepted Answer

A licensed physician who is qualified to evaluate your specific condition. We only offer conditions a physician on our panel can properly assess, and each case is assigned to someone appropriate for it. Your letter is written and signed by the physician who reviewed your records and met with you.

Question 6

How long does the whole process take?

Accepted Answer

Most of the timeline is in your hands. Once your records are uploaded and complete, a physician typically reviews them within a few business days, and consultations are usually available within a week or two after that. The letter follows the consultation. Veterans who have their records ready before they start move considerably faster than those gathering them afterward.

Question 7

What happens during the consultation?

Accepted Answer

Your physician will already have read your file. The consultation is where you explain what the records cannot — how the condition started, how it has progressed, how it affects you now — and where the physician asks about anything ambiguous in the documentation. It is a medical records review and opinion, not a treatment appointment: your physician will not diagnose you, prescribe anything, or take over your care.

Question 8

Can I get letters for more than one condition?

Accepted Answer

Yes, but each condition is a separate request with its own intake, records, physician review, consultation, and letter — and its own price. That is because each one is a distinct medical question requiring its own reasoning. Bundling them into a single letter produces a weaker document.

Question 9

Can I see the letter before I pay the balance?

Accepted Answer

No. You are told when the letter is complete and signed, and you can see the physician's opinion classification, but the document itself is released after the balance is paid. Once released it stays in your account permanently and you can download it as often as you need.

Question 10

What does it cost?

Accepted Answer

$895 per condition, flat. You pay $149 to start, which is credited toward the total, and the remaining $746 only after your letter is written and signed. There are no hourly charges, rush fees, or add-ons.

Question 11

What happens if the physician declines to write the opinion?

Accepted Answer

You are not charged the balance. The deposit is retained, because it paid for the records review that produced that answer — real work by a licensed physician, whichever way it comes out. You receive a written explanation of why the evidence fell short and what additional evidence could change it. Many veterans find that explanation useful on its own.

Question 12

Can I get the deposit back?

Accepted Answer

Yes, if you cancel before a physician has been assigned and started reviewing your records, or if we cannot match you with a physician qualified for your condition. Once the review has begun, the deposit is not refundable because the work has been done.

Question 13

Do you take payment plans or VA benefits?

Accepted Answer

The two-payment structure is the payment plan — you pay less than a fifth up front and the rest only if a letter is actually produced. We do not bill the VA, Medicare, or private insurance. Independent medical opinions obtained for a benefits claim are not a covered medical service.

Question 14

Which conditions do you cover?

Accepted Answer

We cover conditions our physicians are qualified and licensed to evaluate, including mental health, musculoskeletal, respiratory, neurological, hearing, digestive, cardiovascular, and endocrine conditions. The full list is on our conditions page. If yours is not there, contact us before paying anything — we may be able to help, or we may tell you we cannot.

Question 15

Do I need a current diagnosis?

Accepted Answer

Yes. A nexus letter connects an existing diagnosis to your service. It cannot establish the diagnosis itself. If you do not yet have one, see a provider and get evaluated first — without a current diagnosis, there is nothing for the opinion to connect.

Question 16

My claim was already denied. Can you still help?

Accepted Answer

Often, yes, and previously denied claims are a substantial share of our work. What matters is why it was denied. If the VA said there was no medical evidence linking the condition to service, that is exactly the gap a nexus letter fills. Upload the denial letter with your records — the physician will read the VA's stated reasoning and address it directly.

Question 17

Are you accredited to represent me with the VA?

Accepted Answer

No, and we do not act as your representative. We provide medical evidence, not claims representation. We do not file claims, appear before the VA, or give legal advice. For representation, work with a VA-accredited attorney, claims agent, or a Veterans Service Organization — many VSOs provide that free.

Question 18

What records do I need to send?

Accepted Answer

At minimum: your DD-214, your service treatment records, current medical records showing the diagnosis, and any VA rating decision or denial letter. Specific conditions need more — a sleep study for sleep apnea, imaging for a spine claim, audiograms for hearing. Your case shows a checklist tailored to the condition you selected.

Question 19

I do not have my records. How do I get them?

Accepted Answer

Service treatment records and your DD-214 can be requested from the National Archives, and most post-2000 records can be downloaded from the VA's own systems. VA treatment records can be requested through your VA medical centre's release of information office. Private records come from the provider who treated you. It takes time, so start before you need them.

Question 20

Is there a deadline for uploading records?

Accepted Answer

Your records need to be complete at least 72 hours before your consultation so the physician has time to read them properly. If they arrive later than that, we will reschedule rather than have a physician skim your file on the morning of the appointment.

Question 21

Who can see my medical records?

Accepted Answer

You, the physician assigned to your case, and the administrators who support the case. Nobody else. Every access to a document is logged with the identity of the person who opened it and when. We do not sell your information, share it with claims agents or law firms, or use it for advertising.

Question 22

Are you HIPAA compliant?

Accepted Answer

As a private company providing independent medical opinions rather than treatment, we are not a HIPAA covered entity across most of what we do. We apply equivalent protections regardless: encryption in transit and at rest, a second layer of application-level encryption on clinical content, role-based access control, audit logging of every record access, and a minimum-necessary standard for staff. Our privacy practices page sets out the specifics.

Question 23

How long do you keep my records?

Accepted Answer

Your letter stays available in your account for as long as you keep the account. Supporting records are retained for the period required by medical records retention standards and then securely destroyed. You can ask us to delete your account and records at any time, subject to what we are required to retain.

Everything veterans ask us

Nexus letter basics

How our process works

Pricing and refunds

Whether we can help you

Records and appointments

Privacy and security

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