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FAQ
What a nexus letter is, what it costs, who signs it, and what we will not do. Written for veterans and for the engines that quote us.
- What is a VA nexus letter?
- A nexus letter is a written medical opinion that answers whether a veteran’s current condition is connected to military service. The VA standard is “at least as likely as not,” meaning 50 percent or greater. Line of Duty Medical writes these as independent medical opinions after a physician reviews the complete claims file.
- How much does a nexus letter cost?
- At Line of Duty Medical, a nexus opinion is $1,250 for one connection or $1,500 for an opinion covering two or three. Every case starts with a flat $350 records review. If the case proceeds, $150 of that review is credited toward the opinion, so a single-connection nexus is $1,450 all together. National prices in 2026 typically run $500 to $2,000 depending on credentials and whether the review is credited.
- What is a DBQ, and when do I need one?
- A Disability Benefits Questionnaire is the VA’s own exam form. It is used to rate severity after service connection is already established, or to counter a weak C&P exam. We complete DBQs at $500 from your records, or $750 with an in-person examination in Evans, Georgia.
- Is an independent medical opinion the same as a nexus letter?
- Yes, in VA practice the two terms describe the same work: a physician’s reasoned opinion on service connection. “Nexus letter” is the common veteran phrase. “Independent medical opinion” or IMO is the formal name. We use both. The document is not a form letter. It cites your records and the medical literature that supports the connection.
- Who writes and signs the opinion?
- A licensed physician writes and signs every opinion. Two physicians review the file before it is signed: one is a U.S. Army veteran who deployed, and the other has 30 years of medical practice, including board certification in Physical Medicine and Rehabilitation. We do not use rotating anonymous panels or unsigned templates.
- Why does a physician-signed letter cost more than one from a PA or NP?
- Many national shops price $500–$800 letters written by physician assistants or nurse practitioners, often from home or while on duty at a military treatment facility. Those letters can be accepted. VA raters weigh credentials and rationale together. A physician-signed opinion with page-level citations is the product veterans buy when the claim is contested, on appeal, or already denied.
- Is the $350 records review credited if I move forward?
- Yes. If your claim continues after the written assessment, $150 of the $350 review is credited against the nexus opinion or DBQ. If we tell you in writing that the record cannot support the claim, you have spent $350 and we stop there.
- What if you cannot support my claim?
- We tell you in writing and stop. The records review fee pays for that answer in either direction. We never write an opinion the record cannot carry, and we never take a percentage of back pay.
- How long does a nexus letter take?
- The written records review typically takes 3–5 days after we have a complete file. A standard independent medical opinion takes 2–3 weeks from complete records. Expedited work is available in 72 hours for a 30 percent rush premium.
- Can I pay over time?
- Yes. After the records review, the balance can be split in half 30 days apart, or into three equal monthly card payments, at no extra cost. Each stage of the work is completed and released once payments cover it. We do not work on credit, and no fee is contingent on the claim outcome.
- Do you only serve Georgia veterans?
- No. Record review and nexus opinions are written for veterans nationwide. The practice is based in Evans, Georgia, near Augusta and Fort Eisenhower. In-person DBQ examinations are performed locally. Veterans outside the CSRA use the records-based path.
- Do you file my VA claim or represent me?
- No. Federal law (38 U.S.C. 5901 and 5904) allows only VA-accredited attorneys, agents, and service organizations to charge for preparing or prosecuting a VA claim. We are physicians. Our fees are for medical services: record review, examinations, and written opinions. For filing help, use an accredited representative or a VSO.
- Will the VA pay for my nexus letter?
- Almost never. The VA does not reimburse private nexus letters. Veterans pay before any award exists. That is why we lead with a flat review instead of asking for the full opinion fee before anyone has read the file.
Still deciding whether to spend the review?
Book a consult. We confirm scope and cost before any work begins.