NEXUS LETTERS PRIME
Physician-Led · MD/DO Only · Veteran-Founded
Board-certified physicians only — no PAs, no NPs, no templates. Delivered in 5–7 days with a free revision guarantee.
What We Do
When you file a VA disability claim, you need to prove that your condition is connected to your military service. That proof is called a nexus letter.
A nexus letter is a document written by a licensed doctor that says: "In my medical opinion, this veteran's condition is at least as likely as not caused by their military service."
Without this letter, the VA will almost always deny your claim — even if the connection seems obvious to you. The VA needs a doctor to say it in writing, using the right medical language, backed by evidence from your records.
That's what Nexus Letters Prime does. We connect you with a board-certified physician who reviews your medical and military records, then writes a detailed opinion letter built specifically for VA standards.
You tell the VA about your condition — PTSD, sleep apnea, back pain, migraines, whatever it is. But saying it isn't enough.
The VA requires a licensed doctor to confirm your condition is connected to your service. Without this, your claim is missing its most important piece.
A board-certified MD or DO reviews your records and writes a detailed medical opinion using the exact language the VA requires — backed by peer-reviewed research.
The nexus letter goes directly into your VA claim file. The VA is legally required to consider it. A strong letter tips the decision in your favor.
Why Credentials Matter
The VA assigns different levels of trust to different types of medical professionals. Here's the simple breakdown — and why it matters for your claim.
Nexus Letters Prime Uses
MD / DO
Medical Doctor / Doctor of Osteopathic Medicine
A fully licensed physician who completed medical school, residency training, and passed board certification exams. They have the highest level of independent medical authority — meaning the VA gives their opinion the most weight.
✓ Highest VA Weight
Most Competitors Use
PA-C
Physician Assistant
A mid-level provider who completed a master's program and works under physician supervision. Their medical opinions carry less weight with the VA, especially for complex claims or appeals.
↓ Lower VA Weight
Budget Providers Use
NP
Nurse Practitioner
An advanced practice nurse with a master's or doctoral nursing degree. While they can write medical opinions, C&P examiners and BVA judges may question their authority on complex medical causation.
↓ Lowest VA Weight
Bottom line: When the VA rater is deciding your claim, the doctor's credentials matter. Every Nexus Letters Prime letter is written by an MD or DO — the highest level of medical authority. No PAs. No NPs. No exceptions.
Conditions We Cover
The VA assigns a disability rating (0%–100%) to each condition based on how much it affects your daily life. You can claim conditions that were caused by your service (direct connection) or caused by another condition that's already service-connected (secondary connection). Here are the conditions we write nexus letters for most often.
PTSD
Mental Health
The #1 most claimed mental health condition. We connect your diagnosis to in-service stressors using DSM-5 criteria. Common ratings: 30%, 50%, 70%, 100%.
Major Depression
Mental Health
Often secondary to chronic pain, PTSD, or TBI. Common ratings: 30%, 50%, 70%.
Anxiety Disorders
Mental Health
Service-connected anxiety from combat, MST, or high-stress environments. Same rating scale as PTSD.
Sleep Apnea
Direct & Secondary
Highest-value secondary claim. Commonly linked to PTSD. Rated 0%, 30%, 50%, or 100%.
Tinnitus
Direct
Most claimed VA condition. Rated at 10%. Noise exposure from weapons, aircraft, machinery.
Migraines
Direct & Secondary
Commonly secondary to TBI, PTSD, or cervical spine. Rated 0%–50% based on frequency.
Hypertension
Direct & Secondary
Often secondary to PTSD or sleep apnea. Strong medical literature supports the link.
Diabetes Type II
Presumptive & Direct
Presumptive for Agent Orange. Also claimable direct or secondary. Rated 10%–100%.
GERD / IBS
Direct & Secondary
Commonly secondary to PTSD medications. Rated 10%–60%.
Back & Neck
Musculoskeletal
From carrying gear, vehicle impacts, parachute jumps. Rated under limitation of motion.
Knee Conditions
Musculoskeletal
Ruck marching and tactical movements cause chronic degeneration. Dual ratings possible.
TBI
Neurological
Blast exposure and concussions. Opens the door to numerous secondary claims.
Sinusitis / Rhinitis
Respiratory
Connected to burn pit exposure or desert environments. PACT Act expanded eligibility.
Skin Conditions
Dermatological
Chemical exposure and tropical climates. Rated 0%–60% based on body area.
Erectile Dysfunction
Secondary · SMC-K
Secondary to PTSD meds, diabetes, or spinal conditions. Rated at 0% but qualifies for Special Monthly Compensation (SMC-K) — an extra $139.67/month on top of your regular check.
Hearing Loss
Direct
Noise exposure from weapons and machinery. Often paired with tinnitus claims.
Respiratory / Asthma
Burn Pit & Direct
PACT Act presumptives for burn pit, oil well, and airborne hazard exposure.
Chronic Fatigue
Gulf War & Secondary
Presumptive for Gulf War veterans. Also secondary to sleep apnea or PTSD.
Shoulder Conditions
Musculoskeletal
Rotator cuff, labral tears from overhead work, combat, PT.
+ More Conditions
Contact Us
We cover virtually every VA-rated condition. Schedule a free consultation.
VA Disability Increase Calculator
The VA pays monthly tax-free compensation based on your combined disability rating. Adding even one condition can increase your check by hundreds — sometimes thousands — of dollars per month.
Select the VA rating percentage for the condition you want to add. If you're not sure, ask during your free consultation.
The VA pays more if you have dependents. Only applies to ratings of 30% or higher.
Real Impact
The VA uses "VA math" — your ratings don't simply add up. Instead, each new condition is applied to what's left of your remaining healthy percentage. Even a small condition added on top of an existing rating can mean hundreds more per month. Here are real scenarios.
Sleep Apnea — Secondary to PTSD
Added 50% for OSA
+$553/mo · +$6,646/yr
Hypertension — Secondary to PTSD
Added 10% for HTN
+$292/mo · +$3,514/yr
Migraines — Secondary to TBI
Added 50% for Migraines
+$1,836/mo · +$22,037/yr
Process
Getting a nexus letter shouldn't be complicated. Here's exactly what happens when you work with Nexus Letters Prime — no surprises, no confusion.
Schedule a call. We'll review your situation, explain which nexus letters you need, and answer every question. No cost, no obligation.
Send us your DD-214, service treatment records, and current medical documents. Don't worry if your records aren't organized — we'll sort them out.
A board-certified MD or DO personally reviews your entire file. They identify the medical connection between your service and your condition, then write the opinion.
You receive a signed nexus letter with full medical rationale, peer-reviewed citations, and VA-compliant language. Ready to submit with your claim.
Compare Providers
There are dozens of companies offering nexus letters. The differences that actually matter: who writes it (MD vs PA vs NP), how fast you get it, whether they guarantee their work, and what happens if you need help beyond the letter. Here's the honest side-by-side.
| Feature | Nexus Letters Prime | Claim Climbers | Xterra Health | VA Claims Insider | Prestige Veteran | PTSD NC | The Nexus MD | EMRA |
|---|---|---|---|---|---|---|---|---|
| Provider Credentials | MD/DO Only | Varies | MD (Varies) | Network | PA-C | MD (Psychiatrist) | MD | PA/NP to MD |
| Free Consultation | ✓ | ✗ | ✓ | ✓ | ✗ | ✓ | ✓ | ✗ |
| Turnaround Time | 5–7 Days | 7–10 Days | 24–48 Hours | Coaching-Based | ~48 Hours | Not Public | Not Public | Not Public |
| 48hr Rush Available | ✓ | ✗ | Standard | ✗ | $200 Extra | ✗ | ✗ | ✗ |
| Mental Health + Physical | ✓ All 20+ Conditions | ✓ | ✓ | ✓ | ✓ | Mental Only | ✓ | ✓ |
| Revision Guarantee | ✓ Free Revision | Money-Back | Free Revision | Pay-for-Results | ✗ | ✗ | ✗ | ✗ |
| Payment Plans | ✓ | Klarna/Affirm | ✗ | Post-Result Fee | Available | ✗ | ✗ | ✗ |
| Price Range | Flat Rate | $795+ | $500 | 6x Increase (Max $15K) | $600 | Not Public | Not Public | $797–$2,000 |
| Claims Consulting | ✓ VA Ratings Prime | ✗ | ✗ | Coaching Model | ✗ | ✗ | ✗ | ✗ |
| Veteran Founded | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✗ | ✗ |
Testimonials
Partner Company
A nexus letter is one piece of your VA claim. But there's more to it — you need a strategy for which conditions to file, what evidence to gather, how to prepare for your C&P exam, and what to do if you're denied. Nexus Letters Prime writes your nexus letter. VA Ratings Prime handles everything else. 500+ veterans served through one ecosystem built to maximize your rating.
500+
Veterans Served
Full
Claims Consulting
Free
Initial Review
Resources
Knowledge is the best weapon in a VA claim. These guides cover the topics most veterans get wrong — or never learn about until it's too late.
Credentials
The VA weighs physician-authored opinions differently than mid-level providers. Here's the hierarchy — and why it directly affects your claim outcome.
Read More →Cost Breakdown
Market prices range from $500 to $2,000. What you get at each tier, hidden fees to watch for, and why the cheapest letters often get denied.
Read More →Appeals
A denial isn't the end. HLR, Supplemental, or Board appeal — here's which path to take and how a nexus letter qualifies as new evidence.
Read More →Get Started
Start with a free consultation — we'll review your situation, tell you exactly what you need, and give you a clear price. No pressure, no obligation. Free revision guarantee. Payment plans available.
FAQ
Everything you need to know about nexus letters, the VA claims process, and how Nexus Letters Prime works. If your question isn't here, ask during your free consultation.
A nexus letter is a written medical opinion from a licensed doctor that connects your current health condition to your military service. Think of it as a bridge — on one side is your diagnosis (PTSD, sleep apnea, back pain, etc.) and on the other side is your time in the military. The doctor's letter explains why the two are connected, using medical evidence and the specific language the VA requires. Without this letter, most claims get denied because the VA needs a medical professional to make the connection — they won't take your word for it.
A board-certified physician with an active NPI, current state medical license, and malpractice insurance. They personally review your records. No templates, no boilerplate.
The basics: your DD-214 (the document you got when you separated from the military), your service treatment records (medical records from when you were in), and any current medical records showing your diagnosis. If you have buddy statements (written statements from people who served with you), deployment records, or treatment history, those help too. Don't worry if your records are messy or incomplete — we'll help you figure out what you have and what you need.
5–7 business days standard. 48-hour rush for pending C&P exams or BVA deadlines.
Yes — the VA is legally required to consider all competent medical evidence submitted with your claim. They can't ignore a properly written nexus letter from a licensed physician. Under federal law, if the evidence is roughly equal for and against your claim, the VA must give you the benefit of the doubt. That's why a strong nexus letter is so powerful — it tips the scale in your favor.
Absolutely. If you were denied before, you can file what's called a "supplemental claim" — which is basically saying "here's new evidence you didn't have before." A nexus letter counts as new and relevant evidence. Many of our clients were denied once (or multiple times) and then got approved after submitting a nexus letter with their supplemental claim. A denial is not the end — it's just a sign you need stronger evidence.
Competitive flat-rate pricing. No hidden fees, no per-page charges. Payment plans are available. Schedule a free consultation for a clear quote.
A C&P exam (Compensation & Pension exam) is a quick appointment the VA schedules for you — usually 15 to 30 minutes with a doctor the VA hired. They're often rushed and the examiner may not have time to fully review your records. Our nexus letter is different: a board-certified physician spends hours reviewing your complete medical history and writes a thorough, evidence-based opinion. The VA must weigh both pieces of evidence. A detailed nexus letter can outweigh a brief C&P exam finding.
An MD (Medical Doctor) or DO (Doctor of Osteopathic Medicine) is a fully licensed physician — they completed medical school, years of residency, and passed board exams. A PA (Physician Assistant) has a master's degree and works under physician supervision. An NP (Nurse Practitioner) is an advanced practice nurse. While PAs and NPs can write nexus letters, the VA raters and judges at the Board of Veterans' Appeals give more weight to opinions from MDs and DOs because of their higher level of training and independent authority. Every Nexus Letters Prime letter comes from an MD or DO.
If your nexus letter doesn't meet VA form-compliant standards, we revise it at no charge. We stand behind the quality of every letter our physicians produce.
Yes. We offer flexible payment plan options so cost doesn't prevent you from getting the medical evidence your claim needs. Ask about available plans during your free consultation.
A secondary service connection means a new condition was caused by a condition you're already rated for. For example: you're service-connected for PTSD, and now you have sleep apnea. Medical research shows PTSD can cause sleep apnea. A nexus letter from a doctor explains this medical link, and the VA can grant you an additional rating for sleep apnea — without you ever having to prove sleep apnea happened during your service. Secondary claims are one of the most common (and most overlooked) ways to increase your rating.
We cover 20+ conditions across every category the VA rates — mental health (PTSD, depression, anxiety, TBI), musculoskeletal (back, neck, knees, shoulders), cardiovascular (hypertension, heart conditions), respiratory (asthma, sinusitis), gastrointestinal (GERD, IBS), sleep disorders (sleep apnea), skin conditions, hearing loss, tinnitus, and more. Unlike some providers who only handle mental health or only handle physical conditions, we handle everything. If the VA rates it, we write it.