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.