VA nexus letter
Nexus letters for VA disability claims.
A nexus letter is the medical opinion that tells the VA whether your condition is connected to service. Ours are written from your complete file, cited to the page, and signed by a physician — not a template and not a percentage of your back pay.
What the VA actually weighs
A reasoned opinion, not a stamp
The legal threshold is “at least as likely as not.” A letter that only states a conclusion carries little weight. Ours walk the rater from your records to that standard.
Your file, cited
STRs, C-file, and treatment records are reviewed in full. The opinion names the pages and dates it relies on. No page ceiling on the review.
A named clinician on the signature line
Every opinion is written and signed by a licensed physician. The signer is licensed, named, and writes within their own scope of practice. That is the difference between this practice and a PA/NP mill writing from home.
What you pay, in order
- Step 01
Start with the $350 records review. A physician reads the whole file and tells you in writing which conditions the record supports — and which it does not.
- Step 02
If you proceed, that $350 is credited in full toward the nexus opinion.
- Step 03
The opinion itself is $1,250 for one connection, or $1,500 covering two or three. Because the review credits away entirely, that is also the all-in price.
- Step 04
The balance can be split, half now and half in thirty days, or into three monthly card payments.
That all-in figure sits with Valor 4 Vet and VetNexusMD, and below Telemedica’s published $1,595 letter plus a separate eligibility review. We do not match the $500 PA/NP shops on price. We match them on honesty: if the record cannot carry the claim, we say so.
By condition
An independent medical opinion is the same product. The medical question changes. These pages explain when the opinion helps and when the questionnaire is the wrong buy.
Sleep apnea
Secondary chains, not a website diagnosis.
PTSD
Opinion for connection. Initial exam stays with VA.
Tinnitus and hearing
No public DBQ. An audiologist does that exam.
Lumbar spine
Connection from the record, or a rating DBQ.
PACT Act / toxic exposure
When presumptive is not the whole answer.
Knee and shoulder
The event, the diagnosis, then the measurement.
Questions veterans ask before they pay
- 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?
- 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.
- 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, $350 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.