What a nexus letter costs, and the other ways veterans pay for help

Is a nexus letter worth it? Here are the ways veterans pay for claim help, what the VA’s rules say about each, and what the Board said when it weighed the results.

A nexus letter is a signed medical opinion that links a current condition to your service. You pay for the opinion. Help with filing or arguing your claim is a separate thing, with its own VA rules.

If you’re comparing prices: ask what the fee covers. A records review? A call? A signed letter? Get the answer before you pay.

If someone wants a share of your back pay: check that they’re VA-accredited first. The VA has a search tool for it.

See what a VA rating pays each month

The ways veterans pay, side by side

The VA’s C&P exam: in most cases, no cost to you. The VA starts it when it needs more information, and you can’t schedule it yourself.
Accredited help: VSO representatives are always free, the VA says. Accredited attorneys and claims agents can charge only after the VA’s first decision on your claim. A fee of up to 20 percent of past-due benefits is presumed reasonable.
Help that isn’t accredited: the VA warns about “claims predators” who try to unlawfully charge a fee for claim help, often promising faster decisions and higher ratings. The VA says the scams grew with the 2022 PACT Act. A bill to fine unauthorized fees, the GUARD VA Benefits Act (H.R. 1732), had a committee hearing on March 18, 2026 and is not law.
A private nexus letter or DBQ: you pay the clinician or service, and the VA doesn’t pay or reimburse a private DBQ. At Anchorpoint, the Nexus Check is free; the letter’s price is on our Prices page.

What the Board looked for

Two of these are fee appeals, where the Board ruled on when an accredited attorney gets paid. The third shows what paying for more letters got one veteran when none of them gave reasons.

An attorney paid from back pay.Granted · 2022
“At the same time, the two parties executed a fee agreement, which provided that the appellant was entitled to 20 percent of any past due benefits awarded to the Veteran, and that the 20 percent was to be paid directly to the appellant by VA.”
The veteran and his attorney agreed on 20 percent of past-due benefits, paid by the VA straight to the attorney. The regional office refused the fee. The Board ruled the attorney was eligible.
Read decision A22021981 on VA.gov (opens in a new tab)
No fee for work before the first decision.Denied · 2026
“Agents and attorneys may not charge fees for services provided before the date on which a claimant or appellant is provided notice of the AOJ’s initial decision with respect to the case.”
The attorney asked for fees on several awards. The Board allowed fees on the conditions the VA had denied once before. It refused the fee where the award came from the VA’s first decision on that claim.
Read decision A26068223 on VA.gov (opens in a new tab)
Three private letters, no reasons.Denied · 2026
“The Board finds that these medical opinions are not probative, as they each do not provide sufficient rationales for how each of these medical professional concluded that the left knee disability was related to the Veteran’s service.”
This veteran sent letters from three private clinicians. Each linked his knee to service. None explained how, and one said service “may have contributed,” which the Board called speculative. The Board went with the VA opinions.
Read decision A26068584 on VA.gov (opens in a new tab)

What you’re paying for in a nexus letter

From the opinions the Board found convincing:

Reasons. In one appeal, the Board turned down three letters because none explained how.
A clinician qualified to give a medical opinion. That’s what the VA counts as competent medical evidence.
A real read of your records, with the pages named.
Your own account and what others saw, checked against the file.
A price you know before you start, and what it includes.
No promise of a rating. Every claim is decided on its own evidence.

Sources

See what your records support

Our Nexus Check reads every page you send and cites the page for each finding, including pages that work against the claim. It’s free. If you request a letter, we draft it, and a licensed clinician reviews it, edits it and signs only what they support.

Get Started See a sample report first

(360) 347-2563 · Mon–⁠Fri 8am–⁠5pm, Sat–⁠Sun 8am–⁠2pm Pacific. Outside those hours, request a call and we respond the next day we’re open.

If we don’t respond the same day during business hours, you get 15% off your nexus letter.

A call, voicemail or text from us counts as our reply. Business hours: Mon to Fri 8 to 5, Sat and Sun 8 to 2 Pacific. Terms

We don’t file claims or contact the VA for you. You or your accredited representative decide how to submit your evidence.

Public Board of Veterans’ Appeals decisions. These veterans weren’t Anchorpoint clients. Every claim is decided on its own evidence.