Let's start your case

A few questions first. Nothing medical yet.

What you tell us matters as much as your records. Under VA law your own account of what you lived through is real evidence, and where it fits the record our physician can rely on it. That cuts both ways, so please answer truthfully and completely — including the parts you think might hurt.

First name

Last name

Date of birth

The VA matches your records by name and date of birth.

Where we send your case link. Please double-check it.

Mobile number

For text updates only. We never cold-call.

State you live in

How did you hear about us? (optional)

What are you hoping we can do?

Pick the closest one. If you're not sure, say so — that's a real answer.

Connect a condition to my service VA hasn't connected it yet, and I think my service caused it Connect a new condition to one VA already covers A condition caused or worsened by something already service connected I'm not sure yet That's a fine answer — we'll work it out together A rating increase for a condition that is already service connected A physician's opinion on how severe it is now. Not a DBQ, and it never promises or predicts a rating

What condition is this about?

However you'd say it out loud. "My back," "ringing in my ears," "sleep apnea" — all fine.

One condition per letter. Some things count as one: all mental health together (PTSD, depression, anxiety), your spine with any nerve pain down the arms or legs, or the same joint on both sides (both knees). Different joints are different conditions, even if it’s the same arthritis — knees and hips are two letters.

or press Enter

Before you pay

One timing note before you pay. If your claim is at a Higher-Level Review, the VA is not allowed to consider new evidence there — a nexus letter included. Board Direct Review and the Court work the same way. We always recommend talking to a VSO about filing strategy, because we write the medical opinion and cannot advise on filing or file for you. You are welcome to order either way; that call is yours.

About a rating-increase opinion

The opinion is based on your condition as it is now. The physician's assessment is based only on your current records and the current history you describe. It cannot be based on test results you expect to get, a disability you expect to develop, or how severe the condition feels beyond what your records and history show.
What counts depends on the condition. For conditions rated on symptoms, what matters is how often they happen and how they affect you right now: your current work status and ability to keep a job, your ability to keep stable relationships, and how you function day to day. For mental health conditions, the VA rates how much the symptoms affect work and social functioning. Past hospitalizations are part of your history, but the opinion describes how you function today.
For conditions rated on objective findings, such as blood pressure readings, test results, or the treatment required, how you feel day to day cannot substitute for those findings. They must come from your records.
There is no examination. Anything that has to be measured or observed, such as blood pressure, lab or imaging results, or range of motion of a joint or the spine, must already be documented in your records. The physician cannot supply it.
I understand this is NOT a Disability Benefits Questionnaire (DBQ) and NOT an examination. It is an independent medical opinion supporting a rating increase, when the records support one. Based on a review of my records and a structured written history, the physician will describe findings that relate to the VA's rating criteria for my condition.
Your letter may identify which VA rating-schedule level your documented findings match, based on the regulation's own criteria. It does not promise or predict a rating. VA decides your rating.
If the physician cannot support an opinion from my records, I will be told and my deposit will be refunded.

Do I need a letter to get a rating increase?

No. A private medical opinion is not required for a rating increase. When you file for an increase, the VA will usually schedule its own examination, at no cost to you. The VA must provide an exam or opinion when the evidence it has isn't enough to decide the claim. Your VA and private treatment records, and your own written statement about how the condition affects your work and daily life, are evidence the VA must consider, and none of them cost anything. A Veterans Service Officer can help you file, also for free.

When an opinion can help: a VA exam is a single visit. It can miss what your records show over months: how often symptoms happen, how long they last, and what happens on bad days. Our opinion reviews your records, gathers your history in a structured way, and lays out the documented findings next to the VA's rating criteria, with a medical explanation, so the rater has it in one place.

When it won't help: if your treatment records don't document more than your current rating already reflects, or they contradict what you'd want us to say, an opinion from us won't change that. We'll tell you so and refund your deposit. We never promise or predict a rating, and we can't promise any outcome. The VA decides.

Terms

This is not a physician-patient relationship. The physician reviews my records and writes an independent medical opinion; no examination or treatment.
By submitting, I intend to proceed and purchase a nexus letter written by the physician for the condition I’m requesting.
One condition per letter.
There is no guarantee of any VA outcome. The VA makes the decision.
The $149 deposit is fully refundable if the physician determines my case is not supportable — usually decided within 24 hours, before further work begins.
Once viability is confirmed and work on my letter begins, the deposit covers that work and is no longer refundable, unless my case is later determined to be invalid.
When your letter is ready, you receive a preview with the physician’s medical rationale and opinion, along with the invoice. The $400 balance is due then, before the full signed letter is released.
The information and records I provide are accurate, and I authorize Flat Rate Nexus to review them.
We are not VA-accredited agents, attorneys, or a VSO. We can’t advise you on how or when to file, which form to use, or your filing strategy. Our service is limited to the physician’s medical opinion on the nexus between your disability and your service.
The physician chooses the medical connection the records best support, which may differ from the one I had in mind.

I have read everything above and agree to these terms and the full Terms of Service

$149 deposit to start. Refunded in full if our physician determines your case isn't supportable.
The $400 balance is due only after you've previewed your letter's medical rationale and opinion.

Some of our five-star reviews on Trustpilot

"I highly recommend Flat Rate Nexus for their thorough work, reasonable pricing, and willingness to listen. I needed a nexus letter addressing a specific medical condition and its cause. Other nexus providers wanted to focus on a condition that developed afterward because they thought it would be easier to pursue. Flat Rate Nexus listened carefully to my concerns, thoroughly reviewed my records, and addressed the connection I was asking them to evaluate. They also gave me the opportunity to review the letter and request corrections to factual details before it was finalized. That attention to detail meant a lot to me. I would absolutely use them again and highly recommend them to other veterans."

— Robert L., September 2026

"Dr. K provided a rapid turnaround nexus letter to support my supplemental claim. It was no less than 8 pages in length and one of the most robust documents I have ever seen or read. He even uncovered a connection to another service connected diagnosis that I didnt even consider before. I detected one part of the letter that I felt shouldnt be there, and it was promptly connected on the same day. Flat Rate Nexus has the most fair pricing I have seen thus far. It is highly worth the investment to help push your claims through. I thoroughly expect to use Dr. K again as I have developed another late-in-life diagnosis that I do not expect the VA will cover."

— Saul, September 2026

"Well written Nexus letter! This is the second time I've used Flat Rate Nexus. Their service is very quick and professional. Highly recommend."

— Jeff M., October 2026

"I want to acknowledge and thank you for the thoroughness of the Nexus letter you wrote for me. Your knowledge of medicine and the law governing VA claims is worthy of sharing with as many Veterans and their families as possible. I recommend Flat Rate Nexus to any Veteran or widow, like myself. Thank you so much, Dr. K."

— Kathy K., June 2026

Read all of our reviews on Trustpilot

We write a physician's opinion connecting a condition to your service, or to a condition VA already covers, and an opinion on the current severity of a condition that is already service connected. We are unable to perform the following services: DBQs and TDIU (unemployability) cases. An accredited representative can help with those at no cost.