Terms of Service

Effective: March 24, 2026

These terms govern your use of the services provided by Flat Rate Nexus, operated by Kasky Online Health, PLLC ("we," "us," "our"). By submitting an intake form or using our service, you agree to these terms.

Service Description

Flat Rate Nexus provides independent medical opinion letters ("nexus letters") for use in VA disability claims. A board-certified physician reviews your medical records and, if the evidence supports a favorable opinion at the "at least as likely as not" threshold (50% or greater probability), prepares a signed medical opinion letter.

This service is limited to record-based medical opinion letters. We do not perform examinations, provide telehealth visits, prescribe medications, or offer treatment of any kind.

No Physician-Patient Relationship

Use of this service does not establish a physician-patient relationship. The reviewing physician provides an independent medical opinion based on your submitted records. No ongoing care, follow-up, or treatment relationship is created or implied.

No Guarantee of Outcome

A nexus letter is one piece of evidence in a VA disability claim. We do not guarantee that your claim will be approved, that a particular disability rating will be assigned, or that the VA will adopt the opinion expressed in your letter. Claim outcomes depend on the totality of evidence the VA reviews, including C&P examinations, prior decisions, and other factors outside our control.

Appeal Lanes and New Evidence

Some VA review lanes do not accept new evidence. A Higher-Level Review is decided by a senior reviewer on the record already in your file, and a medical opinion obtained afterward cannot be considered in that lane. Board Direct Review and appeals at the Court of Appeals for Veterans Claims work the same way. This affects timing; it is not a judgment about your case.

We recommend that you discuss filing strategy with a VA-accredited Veterans Service Organization or representative. We prepare medical opinion letters only — we do not advise on filing strategy, do not select forms or lanes for you, and do not file or represent you before the VA.

Pricing and Payment

Our pricing is a $149 deposit at intake and $400 due at invoicing, before your letter is released — $549 total. Payment plans are available on both charges.

If we determine that your case does not meet the threshold for a supportive opinion, the $400 letter fee is not charged and your $149 deposit is refunded in full. You will receive a specific explanation of why your case was not supportable and actionable steps you can take. Once our physician confirms your case is supportable and begins authoring your letter, the deposit is no longer refundable, including for a change of mind.

Pricing is subject to change. The rate in effect at the time you submit your intake form applies to your case.

Refund Policy

The $149 deposit is refunded in full if our physician determines we cannot support your case. It covers the physician's time reviewing your records and evaluating your case. Once the physician confirms your case is supportable and begins authoring your letter, the deposit is no longer refundable, including for a change of mind. If your case is not supportable, the $400 letter fee is not charged.

Once a completed letter has been delivered and the $400 letter fee has been paid, refunds of the letter fee are not available, as the service has been fully rendered. If you identify a factual error in your letter based on your records, we will correct it at no additional charge, for as many rounds as it takes, within 30 days of delivery. See Revisions below for what we can and cannot change.

Your Responsibilities

You are responsible for providing complete and accurate records. The quality of the medical opinion depends on the completeness of the records you submit. If we need additional records to evaluate your case, we will notify you and provide specific guidance on what to obtain.

You represent that you are the veteran named in the submitted records, or that you are authorized to submit records on behalf of the named veteran.

You consent to the use of AI-assisted tools in the preparation of your letter, as described in our Privacy Policy. The physician reviews, edits, and signs every letter before delivery.

One Condition Per Letter

Each letter addresses one medical condition. If you are seeking opinions for multiple conditions, each condition is handled as a separate case at the same flat rate.

State Restrictions

We are currently unable to accept cases from veterans residing in Oregon or Utah. We serve veterans in all other 48 states and Washington, DC.

International Availability

Services are available to US veterans residing internationally, including (but not limited to) the Philippines, Germany, Japan, Korea, Mexico, Thailand, the United Kingdom, and Guam. All records must be provided in English or professionally translated before review. The $149 deposit does not cover translation costs. Due to US sanctions, we cannot serve veterans residing in Iran, North Korea, Cuba, Syria, Russia, Belarus, or the Crimea, Donetsk, or Luhansk regions of Ukraine. This list may change as US sanctions evolve, and we reserve the right to decline service to residents of any country subject to US economic sanctions.

Record Handling

Your medical records and personal information are handled in accordance with our Privacy Policy and applicable HIPAA requirements. We do not share your records with third parties for marketing or any purpose unrelated to preparing your nexus letter.

Communication

All communication regarding your case is conducted via email at info@flatratenexus.com. We do not offer phone calls, video visits, or in-person consultations. We aim to respond to emails within 2 business days.

Revisions

Please wait until you have the final letter before sending feedback, and send everything in one message. Every corrected letter goes back to the signing physician for review and a new signature, which is what keeps a signed medical opinion legitimate, so each round takes real time and each additional pass is another opportunity for a new error. One pass is faster and cleaner for you.

Factual corrections. If your letter contains a factual error based on your records, tell us and we will correct it at no additional charge, for as many rounds as it takes to get it right, within 30 days of delivery. Factual corrections are typically back to you within 5 business days.

Emphasis and approach. Within 30 days of receiving your letter, you may also request one round of reasonable edits based on your feedback: that we developed a point too lightly, gave weight to something minor, missed context you consider important, or should speak more directly to a specific prior denial. We adjust how the argument is built and where the weight sits.

After 30 days. We will not put two versions of the same signed opinion into circulation. Once your letter has been with you for 30 days we do not revise it — by then it is a signed document the VA may already hold, and two documents presenting the same physician’s opinion with different content can weaken the very evidence you filed. If something needs addressing after that, it becomes an addendum, a memorandum, or a new letter if the theory has changed. We will tell you which, and what is involved, before doing anything. There is a practical reason as well: we do not keep your medical records indefinitely. Holding sensitive health information longer than we need it is a risk to you, so records are purged periodically in line with applicable law, and revising a letter means working from the full record set it was built on.

The medical opinion itself. We do not change the conclusion, the probability level, or the causal theory. That is the physician's independent professional judgment. An opinion that changes on request is advocacy rather than an independent medical opinion, and a VA rater gives it less weight, not more.

On new records. The window for records is before we draft. If something surfaces afterward, send it and we will look at it, but new evidence generally is not a correction. It can change which argument is strongest, and that means rebuilding the letter rather than adjusting a paragraph. We will tell you what is involved before we do anything.

Intellectual Property

The nexus letter prepared for you is for your personal use in connection with your VA disability claim. You may submit it to the VA, share it with a Veterans Service Organization (VSO) or claims agent, or provide it to an attorney representing you in your claim. You may not resell, redistribute, or publish the letter for any other purpose.

Limitation of Liability

To the maximum extent permitted by law, our total liability for any claim arising from or related to this service is limited to the amount you paid for the specific letter at issue. We are not liable for indirect, incidental, consequential, or punitive damages, including but not limited to lost benefits, claim denials, or delays in claim processing.

Governing Law

These terms are governed by the laws of the State of Nevada. Any disputes arising from these terms or your use of our service shall be resolved in the courts of the State of Nevada.

Changes to These Terms

We may update these terms from time to time. Changes will be posted on this page with an updated effective date. Your continued use of our service after changes are posted constitutes acceptance of the updated terms.

Contact

For questions about these terms, contact us at info@flatratenexus.com.