Your Records. Our Physician.
Your Nexus Letter.

A nexus letter is an independent medical opinion from a physician stating that your current medical condition is "at least as likely as not" connected to your military service. The VA uses nexus letters as evidence when deciding disability claims. A strong nexus letter explains the medical reasoning behind the connection and is supported by your records.

Not always. If your condition qualifies for presumptive service connection (for example, under the PACT Act for toxic exposure or burn pit conditions), the VA may grant your claim without one. Your Veterans Service Organization (VSO) can help determine whether a nexus letter would strengthen your claim. For most non-presumptive direct and secondary claims, a nexus letter significantly improves your chances of approval.

A board-certified physician in Family Medicine or Internal Medicine with an active, unrestricted medical license reviews every record and personally signs every letter. This is not a template factory — each letter is individually drafted based on your specific records and medical history. Our team has no treatment relationship with you, which is what makes this an independent medical opinion.

Our standard turnaround is two weeks from the date we receive your complete records. We guarantee delivery within four weeks. If we are unable to deliver your letter within four weeks, you will receive a full refund.

If after reviewing your records our team determines that a supportive nexus opinion cannot honestly be provided, you are not charged the $350 letter fee. You will receive a written explanation of why we could not support the claim and, where possible, specific guidance on what additional documentation or steps might strengthen a future request. If we can't support your case, you keep a physician's written analysis of why and what would strengthen it.

At minimum: your DD-214 and documentation of your current diagnosis (specialist report, imaging, sleep study, or doctor's note with the diagnosis). For secondary claims, you also need your VA rating decision showing the primary condition is service-connected. Service treatment records and buddy statements are helpful but not always required. Our intake form will guide you through exactly what to upload based on your specific condition.

A few important ways. Every letter is reviewed and signed by a physician who is board-certified in a primary care specialty whose scope of practice covers every condition we write letters for — nothing is outside our lane. Our letters are individually drafted from your records — not templates with your name swapped in. We operate on a flat-rate model with no complexity surcharges, and our standard turnaround is two weeks when many services take six to eight. We also run every case through a viability review before writing — if the evidence doesn't support a nexus opinion, we tell you why and don't charge you the letter fee.

Call us at (877) 583-8225 or email info@flatratenexus.com. We typically respond within one business day. Please don't send medical records via email — you'll upload those securely through the intake form.