Nexus Veteran MD
How It Works
Getting a medical opinion for a VA claim is simpler than most veterans expect. You tell us about your claim, send us your records, and a physician reviews the evidence to determine whether a supportable medical opinion can be written. If it can, we prepare it. If it can’t, we tell you before you’re left holding a document that won’t help.
Here’s what that looks like in practice.
Step 1 — Tell Us About Your Claim
Start by telling us what you’re claiming and where things stand.
Helpful details include:
- The condition you’re claiming
- Any conditions already service-connected, and at what rating
- Relevant military history: where you served, what your duties involved, any injuries or exposures
- When symptoms began and how they’ve progressed
- Current treatment and medications
- Whether you’ve filed before, and what the VA decided
You don’t need all of this to get started, and you don’t need to have it organized. If you’re not sure whether something is relevant, mention it; it’s easier for us to set aside information we don’t need than to ask for something you didn’t know mattered.
If you’ve been denied, the decision letter itself is one of the most useful things you can share. It tells us exactly what the VA found missing.
Step 2 — Submit Your Medical Records
A medical opinion is only as strong as the records behind it. The more complete your file, the more thorough the review.
Records that commonly matter:
- VA medical records and treatment notes
- Private medical records, including specialist evaluations
- Service treatment records and military personnel records
- Diagnostic reports imaging, lab results, sleep studies, audiograms
- Medication history, including start dates and changes
- Prior C&P examination reports
- VA rating decisions and claim correspondence
- Any medical opinion already in your file
Not every veteran needs every item. What matters depends on your condition and your theory of the claim.
One thing worth knowing: send the complete records, including anything you think might be unfavorable. A physician who sees the whole picture can address a problem in the evidence. One who’s surprised by it later cannot.
Step 3 — Your Medical Evidence Is Reviewed
A physician reviews the file to understand your case as a whole.
That review looks at your current diagnosis and the clinical findings supporting it, your symptom timeline and how it lines up with your service or with an already service-connected condition, your treatment history and how you’ve responded, and the alternative explanations an adjudicator will raise age, civilian injuries, occupational history, body weight, and other conditions.
That last part matters more than it might seem. An opinion that ignores an obvious alternative explanation is easy for the VA to set aside. One that addresses it directly is far harder to dismiss.
Step 4 — A Medical Opinion Is Determined
This is the step that distinguishes a real medical opinion from a form letter.
A physician determines whether the evidence supports a medically defensible conclusion and if so, on what theory:
- Causation — the service-connected condition, or its treatment, produced the claimed condition
- Aggravation — it worsened a condition that already existed, beyond its natural progression
These are different medical questions requiring different evidence, and choosing the wrong one costs veterans claims. Where aggravation applies, the opinion has to establish what the condition looked like before the worsening began.
The physician also considers the relevant medical literature and how it applies to your specific history not as a general citation, but as reasoning tied to your record.
We don’t write opinions to order. If the evidence supports a favorable conclusion, the opinion says so and explains why. If it doesn’t, we tell you that instead. A physician who will decline a case is a physician the VA has reason to credit which is exactly what makes the opinions worth submitting when we do write them.
Step 5 — Your Nexus Letter or DBQ Is Prepared
Where the evidence supports it, we prepare the document.
A nexus letter typically includes:
- The physician’s credentials and qualifications
- A list of the records reviewed
- Your current diagnosis
- The relevant medical and service history
- The medical rationale the reasoning connecting your evidence to the conclusion
- Discussion of alternative causes
- Supporting medical literature where it applies
- Analysis of causation and, where relevant, aggravation
- A clear conclusion stated in VA’s standard language: at least as likely as not
We also prepare Disability Benefits Questionnaires, which document how severe a condition is rather than where it came from. A claim may need a nexus letter, a DBQ, or both, depending on what’s missing from your file.
What You Should Have Ready
A short checklist to gather before you start. Requirements vary by case, and missing items don’t stop you from beginning.
- Your current diagnosis
- Medical records VA and private
- Service treatment and personnel records
- Documentation of any service-connected conditions and their ratings
- Medication history
- Treatment history, including specialists, therapy, procedures, or surgery
- Your VA decision letter, if you’ve been denied
- Prior C&P examination results
- Any medical opinion already in your file
If you’re missing something, say so. Some records can be requested, and sometimes what you have is enough.
How Long Does the Process Take?
The process from start to finish is about 30 days. The clock starts as soon as we receive all of the proper and requested information. Examples of some of the typical information we ask for include DD214, Prior Rating Decisions if applicable, Condition Specific Data for example sleep apnea we ask for Sleep Study and Prescription for the diagnostic equipment.
What We Can and Cannot Do
What we do: review your records, evaluate the medical evidence, and provide a physician-written medical opinion or DBQ based on what that evidence actually supports.
What we cannot do: guarantee an outcome. Specifically, we cannot guarantee VA approval, a particular disability rating, any amount of compensation, eligibility for Special Monthly Compensation, or success on appeal.
The VA weighs all the evidence in your file, applies its own rules, and makes its own decision. A medical opinion is evidence, often the missing piece, but it is not a decision.
We are also not a law firm. We don’t provide legal advice or represent veterans before the VA. If you have questions about deadlines, appeal options, or your legal rights, a VA-accredited attorney, claims agent, or Veterans Service Organization can help, often at no cost.
Any company promising you a specific rating or guaranteed approval is telling you something no private company can deliver.
Start Your Evaluation
If you’re not sure whether your records support a claim, that’s a reasonable place to start it’s the question the review is designed to answer.
We also work with attorneys and accredited representatives building case files.