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Nexus Letter Direct

The process

What happens, in what order

Six steps from choosing a condition to downloading a signed letter. Each one unlocks the next, and your case page always shows which step you are on and what is holding it up.

  1. Step one

    Choose a condition and complete intake

    You select the single condition you need an opinion for, then answer questions written for that condition specifically — not a generic form. A sleep apnea intake asks about your AHI and CPAP prescription. A tinnitus intake asks about your MOS and hearing protection.

    15 minutes

    • Create an account with an email address and password.
    • Tell us whether you are claiming direct service connection, secondary service connection, or aggravation of a pre-existing condition.
    • Answer the general and condition-specific intake questions. You can save and return at any point.

    Have ready: Around 15 minutes, and your basic service dates.

  2. Step two

    Pay the deposit

    The $149 deposit opens your case and pays for the physician's review of your records. It is credited toward the $895 total, so the balance afterward is $746.

    2 minutes

    • Payment is processed by Stripe. We never see or store your card number.
    • Paying unlocks document uploads and scheduling.
    • Refundable in full if you cancel before a physician begins your review.

  3. Step three

    Upload your records

    Your case shows a checklist built for your condition. Upload what you have, mark the list complete, and tell us about anything you cannot get — sometimes a missing document changes the approach rather than stopping it.

    Depends on what you already have

    • Drag and drop PDFs or photos of documents. Files are encrypted before they leave your browser's connection.
    • Label each file by type so your physician can find what they need quickly.
    • Records must be complete at least 72 hours before your consultation.

    Have ready: DD-214, service treatment records, current treatment records, and any VA decision letters.

  4. Step four

    A physician reviews the file

    This is the step most services skip. Before any appointment is scheduled, a licensed physician qualified for your condition reads everything you sent and decides whether the evidence can support a favourable opinion.

    A few business days

    • If the evidence supports an opinion, you move to scheduling.
    • If something is missing, we tell you exactly what would help and pause rather than proceeding without it.
    • If the evidence cannot support a favourable opinion, the physician declines and explains why. You are not charged the balance.

  5. Step five

    Meet your physician

    A scheduled consultation with the physician who read your file. They already know your history — this is where you fill in what the paperwork cannot and they ask about anything ambiguous.

    Usually 30 minutes

    • Choose a time from your physician's available slots.
    • Join from your case page. Nothing to install.
    • This is a records review and opinion, not treatment. No diagnosis, no prescriptions, no ongoing care.

  6. Step six

    Pay the balance and download

    Your physician writes and signs the opinion. You are notified when it is ready, pay the remaining balance, and download the signed letter. It stays in your account permanently.

    Letter typically ready within a week of your consultation

    • The remaining $746 is due before the letter is released.
    • The letter states the opinion, the medical rationale, and the evidence relied on.
    • Download it as many times as you need. Give a copy to your representative and file it with your claim.

If the answer is no

What happens when the evidence is not there

This is a real outcome and it happens. We would rather you know the terms before you pay than discover them afterward.

  • You are not charged the balance

    The $746 is never taken. You pay the deposit only.

  • The deposit is retained

    It paid for a licensed physician to read your entire file and reach a considered conclusion. That work happened.

  • You get a written explanation

    Not a form rejection — the physician's reasoning, and specifically what additional evidence could change the answer.

  • You can come back

    If you obtain the evidence the physician identified, open a new request and we will look again.

Ready to find out where you stand?

Start with the condition. Everything else follows from there.

Start a requestEmail us a question