Independent medical opinion
Independent medical opinions for VA claims and appeals.
An independent medical opinion is a physician’s written analysis of whether a condition is connected to service. Veterans usually call it a nexus letter. The VA calls it evidence. We write it so a rater can follow the reasoning.
How an IMO differs from a C&P exam
C&P examination
The VA schedules it and chooses the examiner; the appointment is often brief and the file is not. Courts have held exams inadequate when required testing is skipped — Correia, for example, requires joint motion measured both actively and passively — or when the history documented in the record goes unaddressed.
Independent medical opinion
You choose the physician, and the work starts with your complete claims file. The opinion cites the pages it relies on and reasons to the VA’s own “at least as likely as not” standard. It does not replace a C&P exam. It puts on the record what the exam left out.
What every opinion of ours includes
Full review of STRs, C-file, and treatment records, with no page ceiling
Nexus reasoning to the VA “at least as likely as not” standard
Citations to the specific pages in your record
Prepared by the case physician, then reviewed and signed by the signing provider
Plain answers
- 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 clinician whose training fits your condition. Nexus opinions are signed by a physician, MD or DO. DBQs are completed by a physician, physician assistant or nurse practitioner, within the scope their license allows. Every signer is named on the document and personally reviews your complete file before signing. We do not use anonymous panels.
- 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.
- How long does a nexus letter take?
- It depends on the records and on how many conditions the opinion covers, so we do not promise a date. We will be in touch as soon as we can at every step. Expedited work is available by agreement for a 30 percent rush premium.