When this helps
A written opinion is most useful after a denial or a weak C&P that ignored the secondary theory. It is also useful when the file shows a service-connected mental-health or respiratory condition and later OSA, and nobody has explained the medical link.
What we do
A physician reviews the claims file, the sleep study, the rating decision, and the conditions already granted. If the record supports a connection, we write an independent medical opinion to the “at least as likely as not” standard and cite the pages we used.
What we do not do
We do not diagnose sleep apnea from a website form. We do not promise a rating. If the study is missing or the theory is not in the record, we say so in the $350 review and stop.
The questionnaire
A sleep apnea DBQ can be completed from records when the diagnostic study is already in the file. An exam is used when severity, not connection, is the open question.
All-in for one connection is $1,250 after the review credit. Two or three connections is $1,500. See pricing and FAQ.
Questions we get first
- Do I need a nexus letter for sleep apnea?
- Often yes when sleep apnea is claimed as secondary. The VA wants a medical chain from an already-service-connected condition to the apnea. An independent medical opinion can write that chain from the complete file. We do not diagnose apnea from a website form and we do not promise a rating.
- How much does a nexus letter cost?
- All-in, a single-connection nexus at Line of Duty Medical is $1,250. Two or three connections is $1,500. That is a $350 records review, a $1,250 or $1,500 opinion, and $350 of the review credited if you proceed. National prices in 2026 typically run $500 to $2,000 depending on credentials and whether the review is credited.