Independent medical opinion
IMO,not a form.
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. The examiner often has minutes with you and little time with your file. You do not choose the examiner, and you do not pay them. An unfavorable exam is common when the record was never actually read.
Independent medical opinion
You hire the physician. The work starts with the complete claims file. The opinion cites the pages it relies on and uses the VA’s own “at least as likely as not” standard. It does not replace a C&P exam. It answers the exam the C&P missed.
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
Personal physician review, edit, and signature — two physicians on every case
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 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.
- 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?
- 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.