A nexus letter is a written medical opinion connecting a diagnosed condition to military service, or to a condition that is already service-connected. For mental health claims it is written by a psychologist or psychiatrist. It states the diagnosis, reviews the relevant history and records, gives an opinion using the VA's "at least as likely as not" standard, and explains the reasoning. The VA treats it as medical evidence in your claim.

A Disability Benefits Questionnaire is a standardized VA form that documents a diagnosis and the current severity of symptoms. For mental health, the two forms are the PTSD DBQ and the Mental Disorders DBQ. The severity section of the DBQ is what the VA uses to assign a rating percentage. The VA removed the public forms from its website in 2020 but continues to accept DBQs completed by qualified private providers.

The DBQ says what you have and how severe it is. The nexus letter says why it is connected to service. A claim for a new condition usually needs both; a claim to increase an existing rating usually needs only the DBQ. Our $850 evaluation includes both documents so you do not have to decide which one you need.

It is the clinical evaluation behind the documents: a records review followed by a structured interview with a licensed psychologist. Some providers call it an IME (independent medical examination) or produce an IMO (independent medical opinion). The terms overlap; what matters is that a qualified clinician evaluated you and signed the result.

It is the VA's evidence standard, meaning a 50 percent or greater probability. A nexus letter that reaches this threshold, with a clear rationale, meets the VA's requirement for service connection. Our letters use this language when the evidence supports it.

A clear diagnosis; a review of service records, medical records, and prior VA decisions; a specific opinion using the VA's probability language; a clinical rationale that cites your records and relevant research; and the credentials and license number of the clinician signing it. Template letters that skip the records review carry little weight.

An independent evaluation reports what the evidence supports. If, after your evaluation, the evidence does not support a nexus, we will tell you before completing the documentation. You still receive your full evaluation report and DBQ, and you decide what to submit. The fee covers the evaluation, not the outcome, in the same way an X-ray costs the same whether or not it finds a fracture. We do not send anything to the VA; you control what goes in your file.