Frequently asked questions

Comprehensive FAQ

What is a medical nexus letter?
A medical nexus letter is a formal written medical opinion that addresses whether a veteran’s current medical condition is related to their military service. For VA disability claims, a nexus letter explains the medical reasoning linking an in-service event, injury, or exposure to a current diagnosis using accepted clinical principles and VA-standard language such as “at least as likely as not.” A nexus letter does not guarantee benefits, but it can provide important medical clarification when service connection is unclear or disputed.

 
Why is a nexus letter important for VA disability claims?
A nexus letter may be important when the VA determines that service connection has not been clearly established. While the VA considers many forms of evidence, a well-reasoned medical nexus opinion can clarify causation by explaining how a current condition is medically related to military service. Nexus letters are evaluated based on their medical reasoning, supporting evidence, and clarity—not the outcome sought.

 
What conditions does Spine Nexus Group evaluate?
Spine Nexus Group evaluates spinal conditions only, including cervical, thoracic, lumbar, and lumbosacral spine disorders. Common conditions include degenerative disc disease, radiculopathy, spinal stenosis, spondylosis, post-surgical conditions, and related spinal pathology. Nexus letters for non-spinal conditions are not offered.

 
Do you write the nexus letters yourself?
Yes. All nexus letters are authored personally from start to finish. Spine Nexus Group does not outsource any portion of the nexus letter to staff or non-provider level clinicians. Each opinion reflects independent clinical judgment following comprehensive medical record review. All review work and writing is completed by an independently licensed Doctor of Chiropractic. 

 
Do you accept every case?
No. Spine Nexus Group is intentionally selective. All cases undergo an initial screening to determine whether a spine-related nexus opinion can be medically supported. Cases that cannot be defended medically are declined. This protects both the veteran and the integrity of the medical evidence.

 
What records are required for case screening?
Relevant service treatment records and post-service medical records related to the spinal condition are required. Additional records, imaging reports, surgical documentation, or prior VA decisions may be requested depending on the case. If available records are insufficient to support a medically defensible opinion, the case may be declined.

 
How long does the process take?
Timelines vary depending on record volume and case complexity. Estimated timelines are discussed after case screening and acceptance. Spine Nexus Group does not offer expedited or rush services.

 
How is pricing determined if I have multiple spine conditions?
Pricing is based on distinct spinal regions, not the number of diagnoses. Multiple diagnoses affecting the same spinal region are typically addressed within a single nexus letter when medically appropriate. Separate spinal regions generally require separate nexus opinions. Final determination is made during case screening.

 
Do you guarantee VA approval or a favorable outcome?
No. Medical opinions cannot guarantee outcomes. VA disability determinations are made by the Department of Veterans Affairs and depend on multiple factors beyond a medical nexus letter. Spine Nexus Group does not guarantee results.

 
Do you offer addendums or supplemental opinions?
If the VA requests clarification or additional explanation after a nexus letter is completed, a supplemental or addendum opinion may be offered for an additional fee. Addendums are limited in scope and are only available for nexus letters authored by Spine Nexus Group.

 
Do you provide medical treatment or VA claims assistance?
No. Spine Nexus Group does not provide medical treatment, therapy, advocacy, claims filing, or benefits counseling. The sole service offered is the preparation of medically defensible medical nexus letters for spinal conditions.

 
Is a chiropractor qualified to author a medical nexus letter?
Yes, when the opinion is rendered within scope of licensure and is medically sound. The VA evaluates medical opinions based on their competency, reasoning, and evidentiary support, not solely on the author’s professional title.

VA case law has established that the probative value of a medical opinion depends on whether it contains clear conclusions, supporting data, and a reasoned medical explanation. Well-reasoned nexus opinions that thoroughly review the record and explain the medical basis for service connection may carry significant evidentiary weight. Additionally, under the VA’s “benefit of the doubt” standard, when evidence for and against a claim is in approximate balance, a competent and well-supported medical opinion may be sufficient to support the claim.

Spine Nexus Group’s nexus letters are authored by independently licensed chiropractic physicians, recognized by the Department of Veterans Affairs as a qualified healthcare provider for spine and musculoskeletal conditions, and are rendered within scope of chiropractic licensure.

 
How do I get started?
To begin, submit an inquiry through the contact form. If your case is appropriate for screening, you will receive instructions for the case screening process. Screening is required before any nexus letter is accepted.