Medical opinion: one connection
$1,250
Total includes the initial review. A written opinion addressing one service connection.
Fees
Know the cost before you decide.
Begin with a written assessment. Choose additional work only after you understand what your records support and the proposed scope.
Your first step
Record review & assessment
Review of your claims file and medical records, with a written assessment of the evidence, limitations, and recommended next steps.
$350
Flat fee, regardless of file size.
The full review fee is credited toward an opinion or DBQ if you proceed. If no further work is appropriate, the assessment is the service you have purchased.
Additional services, if appropriate
The opinion prices below are total fees, including the review credit. DBQs are priced per form. A combined engagement is quoted before you approve it.
Medical opinion: two or three connections
$1,500
Total includes the initial review. One opinion addressing two or three connections.
DBQ from records
$500
Per form, when the physician determines the available records are sufficient.
DBQ with an examination
$750
Per form, including the examination required for that service.
Appeal / rebuttal: complex
$2,500 to $3,500
Rebuttal of an unfavorable examination with full record synthesis. The final fee depends on the agreed scope.
How the credit works
For an opinion covering one connection, pay $350 for the assessment, then $900 if you proceed. Total: $1,250. The review is credited once toward the engagement.
What these fees buy, and what the law allows
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 only: record review, examinations and written medical opinions. For help filing or appealing the claim itself, use an accredited representative or a VSO, whose basic claim help is free.
Connections beyond three are $400 each. Expedited work, when available, carries a 30% premium. We confirm the scope and timing before you approve additional work.
Payment options
The balance may be split into two scheduled payments or three equal monthly card payments, at no added cost. Your engagement terms confirm the payment and release schedule.
Need help with cost? Learn about LOD Access.
Independent of the outcome
Fees pay for medical services. They are not a percentage of benefits or back pay and do not depend on a successful claim.
The VA makes claim decisions. We do not guarantee a rating or a favorable opinion.
Common questions about the fees
- 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.
- 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.
- 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.
- 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.
Confirm the right service for your records.
We explain the scope and cost before work begins.