Nexus letter for your VA claim. $400 flat.
A board-certified physician and Navy veteran reviews your records and writes your medical opinion letter. 10 business days. If we can't support your case, you don't pay for the letter.
Dr. Ryan - Navy veteran, board-certified physician →
Not sure if your case is even worth pursuing?
Run your case against 295,756 actual BVA appeal decisions. We'll tell you what cases like yours typically do, what records you'll need, and whether yours looks supportable. 5 minutes, no payment, no obligation.
Free Viability Check →If your case isn't supportable, we'll tell you. No upsell.
Upload your records and pay the $50 review fee. If we can support your case, you pay $350 for the letter. If not, you don't pay for the letter.
$50 for the review. $350 for the letter, only if we can support your case. Competitors charge $800 to $1,500+.
Most letters delivered within 10 business days. Available to US veterans worldwide.
Questions? | info@flatratenexus.com
We analyze your records against 295,756 BVA decisions before we write.
Take obstructive sleep apnea. A veteran can file OSA as secondary to several conditions. The odds are not the same.
| Claimed path | Without a private opinion | With a private opinion |
|---|---|---|
| OSA linked to PTSD | 53 of every 100 | 75 of every 100 |
| OSA linked to anxiety | 59 of every 100 | 79 of every 100 |
| OSA linked to hypothyroidism | 61 of every 100 | 80 of every 100 |
Favorable outcome means the Board granted the connection in full or in part. Partial grants establish service connection on the issue, with rating questions resolved separately.
Same condition. Two variables. The path you pursue and whether you file with a private medical opinion. On the strongest paths, roughly 4 in 5 veterans see a favorable outcome with a private opinion. Your $50 review runs this analysis on your specific records and tells you which path builds the strongest case.
For the data-curious: Across 6,469 Board of Veterans' Appeals decisions on OSA linked to PTSD (1,720 with a private opinion, 4,749 without), favorable outcomes rose from 52.6% to 75.1%. Odds ratio for a full grant 2.91 (95% CI 2.33 to 3.63), relative risk 2.34, p < 0.0001. These are not estimates from medical literature. We computed them directly from the public record. The Board only hears appealed cases, so these reflect outcomes after an initial denial. Initial decisions at the regional office grant at higher rates.
We have outcome data across every major claim category.
Submit your records ($50)
Select your condition, answer a few targeted questions, and upload your records. The $50 record review fee is applied toward your letter. Takes about 10 minutes.
Review our findings
A board-certified physician reviews your records against peer-reviewed medical literature and sends you a summary: the evidence supporting your claim, how your records align, and how we'd address VA examiner pushback. If your case isn't viable, we tell you, and the $350 letter fee does not apply.
You decide ($350)
Confident in the analysis? Pay the balance and receive your completed nexus letter with full clinical rationale, peer-reviewed citations, and preemptive responses to VA examiner objections.
See full pricing details, payment plan info, and FAQ →
Board-certified physician
Every letter is reviewed and signed by a physician board-certified in a primary care specialty that covers every condition we write letters for - nothing is out of scope.
Individually drafted
No templates. No fill-in-the-blank. Every letter is written from scratch based on your specific records, with condition-specific medical reasoning and citations to peer-reviewed literature.
We only write what we believe
If your evidence doesn't support a nexus opinion at the 50% threshold, we tell you why and don't charge you. You'll never get a weak letter from us just because we wanted the fee.
Flat rate, no surprises
$400 flat rate (normally $500). Same price for a straightforward tinnitus letter and a complex secondary sleep apnea case. No complexity surcharges, no upsells.
Fast turnaround
Most letters completed in less than two weeks. Many services take six to eight weeks with no guarantee.
Honest when we can't help
Rejections come with a real explanation - what was missing, what would strengthen a future request, and what other options exist. If we can't support your case, you keep a physician's written analysis of why and what would strengthen it.
Available worldwide
US veterans in the Philippines, Germany, Japan, Korea, Guam, and beyond get the same service at the same flat rate. Record review happens by email, so distance is never the problem. Read the overseas guide.
Pro Bono Program
For every ten nexus letters delivered to paying clients, one is written at no charge for a qualifying US veteran in financial need. Monthly applications, random lottery, same physician review. Learn more and apply.
| Flat Rate Nexus | Most Services | |
|---|---|---|
| Price | ✓ $400 | ✗ $800 - $1,500+ |
| Written by | ✓ Board-certified physician | ✗ Often unlisted credentials |
| Each letter | ✓ Individually drafted from your records | ✗ Template with your name swapped in |
| Data analysis before drafting | ✓ 295,756 BVA decisions mapped | ✗ None, writes what is asked |
| Viability gate | ✓ We tell you if records can't support a nexus | ✗ No screening, you pay either way |
| See clinical reasoning before paying | ✓ Yes | ✗ No |
| Turnaround | ✓ <2 weeks | ✗ 6-8 weeks |
Auditory / ENT
- Hearing loss
- Sinusitis / rhinitis
- Tinnitus
Cardiovascular
- Cardiac conditions (afib, CHF, CAD)
- Hypertension
Endocrine
- Diabetes (Type 2)
Gastrointestinal
Genitourinary
- Erectile dysfunction
Mental Health
Musculoskeletal
Neurological
- Migraines / chronic headaches
- Peripheral neuropathy
- Radiculopathy
- Sciatica
- Traumatic brain injury (TBI)
Renal
- Chronic kidney disease
Respiratory
- Asthma / reactive airway disease
Sleep
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.
Most letters are completed in less than two weeks from the date we receive your complete records.
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. But honestly, send us everything you have. Your full service treatment records, VA medical records, private doctor's notes, imaging reports, lab work, rating decision letters, buddy statements, personal statements - all of it. We'd much rather have 200 pages to work with than 5. The more records we have, the stronger the letter. You can always upload additional records later if you don't have everything in front of you right now.
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.
Yes, through our Pro Bono Program. For every ten nexus letters we deliver to paying clients, one is written at no charge for a qualifying US veteran in financial need. Eligibility is based on household income relative to the Federal Poverty Level. Applications are reviewed on the first business day of each month and recipients are selected by random lottery from the qualifying pool. Full program details and application form.
Yes. The VA processes disability claims from veterans in more than 100 countries, and record-review nexus letters work the same regardless of where you live. Under Nieves-Rodriguez v. Peake, a physician can render a medical opinion based on thorough record review without any in-person contact. We serve US veterans in the Philippines, Germany, Japan, Korea, Mexico, Thailand, Guam, the UK, and other countries at the same flat rate. Records must be in English (or translated). Residents of countries under US sanctions cannot be served. Read the full overseas guide.
Call us at 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.
Flat Rate Nexus was founded by a Navy veteran with eight years of active duty service who got tired of watching the system work against the people it was supposed to serve. Confusing processes, hidden fees, $1,500 letters that turned out to be templates - he learned how the VA disability claims process actually works, what makes a nexus letter hold up under scrutiny, and built this service to make that accessible to every veteran at a fair price.
Every nexus letter is reviewed and signed by a board-certified physician in Family Medicine or Internal Medicine. Our team holds active board certification through nationally recognized certifying bodies, maintains unrestricted medical licenses, and renders all opinions independently based on thorough record review.
We do not establish a physician-patient relationship. We do not diagnose conditions. We review the records you provide, evaluate the medical evidence, and render an honest independent opinion - supportive or not.
What you can expect
- ✓ Board-certified physician review
- ✓ Individually drafted - not a template
- ✓ Cites specific records and medical literature
- ✓ Addresses known VA denial arguments
- ✓ Flat rate with no hidden fees
- ✓ One revision included at no extra charge
- ✓ Most letters within 10 business days
- ✓ Honest opinion - supportive or not
- ✓ HIPAA-compliant record handling
- ✓ Fully online - no phone or video visits
"I started Flat Rate Nexus because I saw too many veterans paying too much for letters that didn't hold up. Every case we take gets a genuine record review from a board-certified physician. If the evidence isn't there, we tell you before you spend money on a letter."
Physician credentials redacted. All veteran information is fictional.
$50 record review, applied toward your $400 letter. If your case is not supportable, the $350 letter fee does not apply.
Our secure HIPAA-compliant intake form opens in a new tab. It takes about 10 minutes. No documents needed right away -you can upload records during the process.
Open Secure Intake Form →$50 record review at intake. $350 for the letter only if we can support your case.
Here's what happens next:
Save info@flatratenexus.com to your contacts so our emails don't go to spam.
Submit your records and our team will review your case -usually within two weeks.
Start My Nexus Letter$50 record review - applied toward your $400 letter.
Launch Pricing - ends May 25
Have your DD-214 and medical records ready.
Email: info@flatratenexus.com